Aberrant right subclavian artery aneurysm

Ten patients with aneurysm of an aberrant right subclavian artery have been previously reported. Dysphagia is not commonly part of the initial symptomatology, and the diagnosis is usually established by chest roentgenogram, esophagogram, and aortography. If operative intervention is planned, adequate preparation for bypass and thoracic aortic grafting should be made since the aneurysm may also involve the descending thoracic aorta at the site of origin of the aberrant subclavian artery. Since both ischemia of the involved arm and the subclavian steal syndrome may occur after division of the origin of the subclavian artery, resotration of arterial flow in the distal subclavian artery is preferred. An additional patient is reported in whom right subclavian-to-carotid artery anastomosis was used after the subclavian artery aneurysm was removed.

Cricopharyngeal myotomy: treatment of dysphagia

Six patients are presented who underwent cricopharyngeus myotomy for dysphagia. The clinical history and cine studies appear to be the most useful assessments in defining patients with dysphagia who may improve after a myotomy. Etiological factors which may precipitate poor coordination of the swallowing mechanism and a relative cricopharyngeus muscle obstruction include neuromuscular disorders, radical oral surgery, central nervous disease, and idiopathic disorders, although the exact physiology of the cricopharyngeus muscle in health and disease is not as yet delineated, the muscle is being implicated in many problems as the inciting factor of upper esophageal dysphagia. The operation of cricopharyngeus myotomy is a relatively simple procedure and should be done with little morbidity and mortality in properly selected cases.

Spontaneous rupture of the pharynx

A case of spontaneous rupture of the pharynx is described occurring during the act of vomiting. Comparisons are made with the only known previously recorded case of spontaneous pharyngeal rupture.

[Cricopharyngeal achalasia in a dog]

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