Complete Esophageal Obstruction Due to Dysphagia Lusoria and Subclavian Artery Thrombosis: A Case Report

TL;DR

A rare case of complete esophageal blockage caused by a blood vessel abnormality and clot is reported, emphasizing the need for early diagnosis and surgery.

Contribution

This case report presents a rare complication of dysphagia lusoria with complete obstruction due to subclavian artery thrombosis.

Findings

A 75-year-old woman experienced complete esophageal obstruction due to an aberrant right subclavian artery with thrombosis.

Conservative treatments failed, necessitating surgical evaluation for definitive management.

Early recognition and multidisciplinary care are crucial for optimal outcomes in such rare cases.

Abstract

Dysphagia lusoria is a rare condition caused by esophageal compression from an aberrant right subclavian artery (ARSA). Although often asymptomatic, complications such as aneurysmal dilation or thrombosis can result in severe presentations, including complete esophageal obstruction.

Herein, we report the case of a 75-year-old woman with a five-year history of progressive dysphagia and significant weight loss. During her hospitalization for urosepsis and acute kidney injury, she developed complete esophageal obstruction, preventing oral intake. Imaging revealed an ARSA with significant parietal thrombosis, compressing the esophagus posteriorly. This confirmed the diagnosis of dysphagia lusoria complicated by ARSA thrombosis. Conservative measures failed, and she was referred for vascular surgical evaluation.

This case highlights a rare but severe presentation of dysphagia lusoria with complete esophageal obstruction due to ARSA thrombosis. Early recognition and multidisciplinary management are critical for optimizing outcomes. Definitive treatment often requires surgical intervention, particularly in the setting of complications like thrombosis.

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