Dysphagia lusoria


Dysphagia lusoria is an abnormal condition characterized by difficulty in swallowing caused by an aberrant right subclavian artery. It was discovered by David Bayford in 1761 and first reported in a paper by the same in 1787.

Pathophysiology

During development of aortic arch, if the proximal portion of the right fourth arch disappears instead of distal portion, the right subclavian artery will arise as the last branch of aortic arch. It then courses behind the esophagus to supply blood to right arm. This causes pressure on esophagus and results in dysphagia. It can sometimes result in upper gastrointestinal tract bleeding.
Investigation of choice - CT angiography

Treatment

Surgical repair is performed. Reconstruction or ligation of aberrant right subclavian artery by sternotomy/by neck approach.

Eponym

David Bayford called it dysphagia lusoria because in Latin, lusus naturæ means sports of nature or natural anomaly. Bayford-Autenrieth dysphagia is eponym for Bayford and Autenrieth.