Right Aortic Arch with a Complete Vascular Ring Causing Tracheoesophageal Compression-A Case Report

右主動脈弓合併完整血管環異常導致氣管食道壓迫－病例報告

柯延昆(Yen-Kun Ko) ； 蕭建隆(Chien-Lung Hsiao) ； 李友仁(Yu-Jen Lee)

《內科學誌》 18卷2期 (2007/04) Pp. 104-107

https://doi.org/10.6314/JIMT.2007.18(2).06

摘要

右主動脈弓合併血管環異常是一種胸腔內大血管的先天性異常，在成人是非常少見的。因為常常會合併先天性心臟血管異常，而且會因為結構壓迫到氣管與食道而產生症狀，所以絕大部分是在兒童時期就會被發現。我們報告一位53歲女性因右主動脈弓異常合併食道後異位與Kommerell憩室，導致氣管食道壓迫產生運動時呼吸困難與吞嚥困難。病患的胸部電腦斷層與肺功能檢查有典型的變化，可作為診斷的依據。因右主動脈弓異常在成人期才產生症狀的病例報告非常的少，而且和運動性氣喘的臨床症狀相似。因此正確診斷可以避免病人使用類固醇，而且唯有開刀才能完全緩解病人的症狀。

並列摘要

Right aortic arch (RAA) with a vascular ring, a congenital malformation of the great vessels of the thorax, is a rare disease in adulthood. Mostly, RAA is accompanied by congenital cardiovascular anomalies diagnosed during childhood, and cause symptoms from the compression of the trachea and/or esophagus. 1 We report a case of a 53-year-old female with a RAA who presented with dyspnea on exertion, dysphagia, and a characteristic images of contrast-enhanced computed tomography (CT) scan, and spirometry. There are a few reports in the literature about symptomatic RAA presented in adulthood, and it may mimic exercise-induced bronchospasm. So diagnosis of this condition may eliminate the need for corticosteroids and the symptoms may resolve completely by surgical intervention only.

並列關鍵字

Right aortic arch ； Vascular ring ； Dyspnea ； Dysphagia ； Computed tomography ； Spirometry