Indian Journal of Anaesthesia  
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CASE REPORT
Year : 2009  |  Volume : 53  |  Issue : 3  |  Page : 358-361

Management of A Patient with Kommerrell's Aneurysm Causing Tracheal and Esophageal Compression


1 Associate Professor, Department of cardiothoracic anesthesiology, Sri Ramachandra Medical College and Research Institute, Porur, Chennai-400116, India
2 Registrar, Department of cardiothoracic anesthesiology, Sri Ramachandra Medical College and Research Institute, Porur, Chennai-400116, India
3 Professor, Department of cardiothoracic anesthesiology, Sri Ramachandra Medical College and Research Institute, Porur, Chennai-400116, India
4 Professor & Head, Department of cardiothoracic anesthesiology, Sri Ramachandra Medical College and Research Institute, Porur, Chennai-400116, India

Correspondence Address:
Ranjith B Karthekeyan
Department of cardiothoracic anesthesiology, Sri Ramachandra Medical College and Research Institute, Porur, Chennai-400116
India
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Source of Support: None, Conflict of Interest: None


PMID: 20640149

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Tracheal and esophageal compression is a well-recognized complication of aneurysms of the aortic arch. Most of the patients present with dysphagia and/or respiratory insufficiency. In the adult population a right-sided aortic arch is often asymptomatic unless aneurysmal disease develops. This usually occurs at the level of the take-off of an aberrant left subclavian artery and is known as a Kommerell's aneurysm.In spite of its rarity, this condition is clinically relevant because of the mortality associated with rupture, the morbidity caused by compression of mediastinal struc­tures, and the complexity of surgery. In many cases, surgical resection of the aneurysm relieves the symptoms. We present a case in which tracheal compression and bilateral vocal cord palsy caused by an aneurysm arising from Kommerrell's diverticulum .The patient developed respiratory embrassement after extubation and was subsequently treated with continue positive airway pressure (CPAP) with a favorable result.


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