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

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.