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Il Giornale Italiano di Radiologia Medica 2018 Luglio-Agosto;5(4):555-60

DOI: 10.23736/S2283-8376.18.00096-7

Copyright © 2018 EDIZIONI MINERVA MEDICA

language: Italian

A rare case of radiologically-diagnosed right-sided aortic arch with retroesophageal origin of left subclavian artery associated with Kommerell’s diverticulum

Giuseppe POSILLICO 1 , Piero TROVATO 2, Mariangela IODICE 1, Luciana PICCOLO 1, Giovanni MOGGIO 3, Luigi MANFREDONIA 1

1 Unità Operativa Complessa di Diagnostica per Immagini, Azienda Ospedaliera di Caserta Sant’Anna e San Sebastiano, Caserta, Italia; 2 Dipartimento di Scienze Biomediche Avanzate, Università degli Studi di Napoli Federico II, Napoli, Italia; 3 Unità Operativa Semplice Dipartimentale di Angio-Radiologia Interventistica, Azienda Ospedaliera di Caserta Sant’Anna e San Sebastiano, Caserta, Italia


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Right-sided aortic arch with aberrant origin of the left subclavian artery represents a rare congenital defect described for the first time by Fioratti and Aglietti over two centuries ago. This condition can be associated with the development of aneurysmal pathology, which usually occurs at the origin of the aberrant left subclavian artery, known as Kommerell’s diverticulum. Kommerell’s diverticulum is a diverticular formation of the aortic arch located at the origin of an aberrant subclavian artery, described for the first time in 1936 by Dr. Friedrich Kommerell. DK may actually be associated with several congenital abnormalities of the aorta and its branches. These vascular abnormalities are generally asymptomatic, but they can sometimes be symptomatic due to ab extrinsic compression of adjacent structures. In the most serious cases, exitus can occur following diverticulum rupture, often found during autopsy or angiographic examinations. However, the recent development and increasingly widespread use of non-invasive level II-III imaging methods, such as computerized tomography and magnetic resonance imaging, has led to an increase in the diagnostic incidence of these conditions, as well as a better characterization of the aortic arch and its branches. We present a case of incidental diagnosis of a right-sided aortic arch with retroesophageal origin of left subclavian artery associated with Kommerell’s diverticulum, obtained by traditional radiographic examination and integration with angio-CT examination of the thoracoabdominal aorta.


KEY WORDS: Diverticulum - Diagnostic imaging - Subclavian artery - Aortic arch syndromes

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