title: Thoracic aortic aneurysm presenting with dysphagia: a fatal delay in diagnosis.
abstract: Extrinsic oesophageal compression leading to dysphagia is a recognised but uncommon sole presentation of thoracic aortic aneurysms. This has been referred to as Dysphagia Aortica, and is a late presentation of large thoracic aneurysms, or a symptom of impending aorto-oesophageal fistula. We present the case of a 67 year old woman who presented repeatedly with dysphagia and weight loss over a 3 month period to specialists in three different disciplines. Eventually, a type II thoraco-abdominal aortic aneurysm causing extrinsic compression of the oesophagus was discovered. When dealing with patients who present with dysphagia, if no other cause is discovered, a thoracic aortic aneurysm should form part of the differential diagnosis, as this is potentially curable, and delays in diagnosis and treatment predispose to rupture and death.
authors.affiliation: Department of General and Vascular Surgery, Dorset County Hospital, Dorchester, UK.
authors.forename: H G
authors.initials: HG
authors.lastname: Hiller
authors.forename: N R F
authors.initials: NR
authors.lastname: Lagattolla