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Case Reports
. 2007 Feb 26:4:Doc01.

Thoracic aortic aneurysm presenting with dysphagia: a fatal delay in diagnosis

H G Hiller  1 , N R F Lagattolla
Affiliations
Case Reports

Thoracic aortic aneurysm presenting with dysphagia: a fatal delay in diagnosis

H G Hiller et al. Thorac Surg Sci. .

Abstract
in English, German

Extrinsic oesophageal compression leading to dysphagia is a recognised but uncommon sole presentation of thoracic aortic aneurysms. This has been referred to as Dysphagia Aortica, and is a late presentation of large thoracic aneurysms, or a symptom of impending aorto-oesophageal fistula. We present the case of a 67 year old woman who presented repeatedly with dysphagia and weight loss over a 3 month period to specialists in three different disciplines. Eventually, a type II thoraco-abdominal aortic aneurysm causing extrinsic compression of the oesophagus was discovered. When dealing with patients who present with dysphagia, if no other cause is discovered, a thoracic aortic aneurysm should form part of the differential diagnosis, as this is potentially curable, and delays in diagnosis and treatment predispose to rupture and death.

Dysphagie infolge äußerer Verengung des Ösophagus ist eine bekannte aber seltene Komplikation bei einem Aneurysma der thorakalen Aorta. Im weiteren Verlauf besteht die Gefahr einer drohenden Ruptur bzw. der aortoösophagealen Fistelbildung.

Wir präsentieren den Fall einer 67-jährigen Frau mit Gewichtsverlust und Dysphagie über drei Monate, die mehrere Spezialisten konsultierte und bei der schließlich eine Ösophagusstenose infolge eines thorakoabdominellen Aortenaneurymas Typ II diagnostiziert wurde.

Differenzialdiagnostisch sollte bei der Dysphagie, insbesondere wenn keine andere Ursache erhoben werden an, an ein thorakoabdominelles Aortenaneuryma gedacht werden, da diese Erkrankung potentiell korrigierbar ist und eine Verzögerung der Behandlung zur Ruptur führen kann.

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Figures

Figure 1
Figure 1. Computerised tomogram showing anterior displacement and compression of the oesophagus by a large thoracic aortic aneurysm
See this image and copyright information in PMC

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