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J Trauma 1991;31(1):17. Historical notes on the therapy of depression. 481484) Diffuse Esophageal Spasm Pathophysiology:nonperistalticcontractioninesophagealsmoothmuscle SSx:odynophagiatosolidsandliquids,dysphagia,chestpain Dx:esophagram(corkscrew,normalLESrelaxation),manometry Complications:diverticuli Rx:nitrates,calciumchannelblockers,anticholinergics,mayconsider dilation and myotomy for severe symptoms Dysphagia Lusoria (Bayford Syndrome) Pathophysiology:anomalousrightsubclavianarteryfromdescending aorta (fourth branchial arch anomaly) has a retroesophageal course causing dysphagia from extrinsic compression of the esophagus associatedwithanonrecurrentrightrecurrentnerve,aorticand subclavian aneurysms, and diverticuli SSx:intermittentdysphagia(usuallypresentsatmiddleagewithlossof elasticity of vessels), weight loss Dx:bariumswallow,arteriogram,esophagoscopy(pulsatinghorizontal bar at obstruction site) Rx:ligateandreanastomosetorightcommoncarotidforsevere symptoms Acknowledgments 99  Lacroix, Z.
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