A neglected symptom of contained aortic laceration--dysphagia aortica successfully treated by endovascular stentgrafting

Abstract

Purpose: Dysphagia aortica describes an esophageal swallowing disorder caused by external compression from an ectatic, tortuous, or aneurysmal thoracic aorta. Although well recognized among specialists, dysphagia aortica is rarely considered in the differential diagnosis of dysphagia.

Case report: We present the case of a 75-year-old woman with a history of swallowing difficulty and retrosternal pressure sensation. Her symptoms had been attributed to sliding axial hernia along with gastroesophageal reflux disease for the last 12 months. Diagnostic workup at our institution revealed a giant penetrating ulcer of the descending aorta as a culprit of esophageal compression. Expeditious endovascular stentgraft exclusion of the aneurysm was performed because of its symptomatic nature and high propensity of spontaneous rupture. On a recent consultation 2 years after the endovascular procedure, the patient confirmed a complete remission of impaired swallowing and freedom from thoracic discomfort.

Conclusions: Dysphagia aortica should be considered in the numerous differential diagnoses of esophageal swallowing disorders in the elderly, as delayed identification may harbor catastrophic outcome for affected individuals.