Case of the Week # 104

Alberto Sosa Olavarría, MD, Luis. Díaz Guerrero, MD, Gelsy Giugni Chalbaud

September 26-October 15, 2003

Centro de Estudios Ultrasonográficos Perinatales. Maternidad Las Acacias. Valencia. Venezuela.

The patient (G1) was referred at 34 weeks of gestation for a routine prenatal ultrasonographic study. The anomaly is on the following images:

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Answer

Case report: The patient (G1) was referred at 34 weeks of gestation for a routine prenatal ultrasonographic study. The study includes the seven images standard utilized for the fetal echocardiographic views, calling the attention the presence of a diverticulum located toward the top end of the thoracic aorta and in the three vessel and trachea view we could observe an anomaly in the position of the major vessels with regard to the trachea.

In the figures 1 and 2 we can observe the normal anatomy of upper mediastinum and the normal ultrasound of the three vessel and trachea view, while in the figures 3 and 4 the ones that show the Kommerell's diverticulum. The left subclavian artery arises from a diverticulum at the junction of the right aortic arch and the right descending aorta. The figure 5 show the three vessel and trachea view in this case, with loss of relations of the trachea with de major vessels (U shape image).

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Figure 1

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Figure 2

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Figure 3

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Figure 4

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Figure 5

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