IMAGES IN EMERGENCY MEDICINE
Right-sided aortic arch with Kommerell’s diverticulum
Department of Radiology, Mackay Memorial Hospital, Taipei, Taiwan
Correspondence to:
Dr R Kuo, Department of Radiology, Mackay Memorial Hospital, 92, Section 2, Chungshan North Road, Taipei, Taiwan; Kuoricha@ms1.mmh.org.tw
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An 83-year-old man came to the emergency department with chest tightness for 3 h. A chest x ray shows widening of the superior mediastinum causing a suspicion of aortic aneurysm. An axial chest computed tomography scan revealed a right-sided aortic arch with Kommerell’s aortic diverticulum (fig 1). A Kommerell’s diverticulum represents a congenital dilatation of the origin of the aberrant left subclavian artery in the right-sided aortic arch. It is the remnant of the embryonic left fourth aortic arch and is often asymptomatic. Occasionally it may cause dysphagia and cough due to indentation of the oesophagus and trachea.1 The patient was treated conservatively and has been followed uneventfully for 2 years.
Figure 1 Computed tomography scan showing right-sided aortic arch (arrowhead) with Kommerell’s aortic diverticulum (arrow).
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Competing interests: None.
Patient consent: Obtained.
- Cina CS, Althani H, Pasenau J, et al.. Kommerell’s diverticulum and right-sided aortic arch: a cohort study and review of the literature. J Vasc Surg 2004;39:131–9.[CrossRef][Medline]
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