J Korean Soc Emerg Med.  2016 Aug;27(4):384-387. 10.0000/jksem.2016.27.4.384.

A Case of Kommerell's Diverticulum with Aortic Dissection

Affiliations
  • 1Department of Emergency Medicine, Soonchunhyang University, College of Medicine, Seoul, Korea. jesumania@gmail.com

Abstract

In 1936, a German radiologist, Burckhard Kommerell, reported a rare variant of thoracic aortic aneurysm named Kommerell's diverticulum which may be accompanied by an aberrant origin of the right subclavian artery. The most common type of Kommerell's diverticulum is the right-sided aortic arch, with the aberrant left subclavian artery. Kommerell's diverticulum is associated with a high risk of early rupture, and 20% is accompanied with aortic dissection. However, because Kommerell's diverticulum is rare, it is highly probably for emergency physicians to overlook the abnormal findings from a chest X-ray or dismiss the potential risk of early rupture and aortic dissection. Symptoms of Kommerell's diverticulum are not specific, like chest pain, dyspnea, swallowing difficulty, and so on. Therefore, it is necessary for emergency physicians to detect Kommerell's diverticulum and avoid premature discharge without consulting a thoracic surgeon for further treatment.

Keyword

Aberrant subclavian artery; Aortic aneurysm; Aortic dissection
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