{{Infobox medical condition (new) | name = Vascular ring | image = | caption = | | pronounce = | field = vascular system | synonyms = | symptoms = | complications = | onset = | duration = | types = | causes = | risks = | diagnosis = | differential = | prevention = | treatment = | medication = | prognosis = | frequency = | deaths = }}
A '''vascular ring''' is a congenital defect in which there is an abnormal formation of the aorta and/or its surrounding blood vessels. The trachea and esophagus are completely encircled and sometimes compressed by a "ring" formed by these vessels, which can lead to breathing and digestive difficulties.<ref>{{Cite web |title=Vascular rings - Overview - Mayo Clinic |url=https://www.mayoclinic.org/diseases-conditions/vascular-rings/cdc-20389579 |access-date=2022-06-12 |website=www.mayoclinic.org |language=en}}</ref><ref>{{Citation |last=Sahni |first=Deepank |title=Vascular Ring Double Aortic Arch |date=2022 |url=https://www.ncbi.nlm.nih.gov/books/NBK558938/ |work=StatPearls |place=Treasure Island (FL) |publisher=StatPearls Publishing |pmid=32644364 |access-date=2022-06-12 |last2=Franklin |first2=Wayne H.}}</ref>
Most often this is because of persistence of the double aortic arch after the second month of fetal life.{{cn|date=October 2021}}
==Presentation== The two arches surround the esophagus and trachea which, if sufficiently constrictive, may cause breathing or swallowing difficulties despite medical therapies.{{cn|date=February 2021}}
A less common ring is present with a right aortic arch instead of the usual left-sided aortic arch. This compresses the esophagus and trachea because of the persistence of a ductal ligament (from fetal circulation) that may connect between the aorta on the front and the left subclavian artery posteriorly going to the left arm.{{cn|date=February 2021}}
==Symptoms==
==Diagnosis== Infants with vascular rings typically present before 12 months with respiratory or esophageal symptoms like stridor, wheezing, cough, dysphagia, or difficulty feeding. The stridor improves with neck extension, differentiating from laryngomalacia which is relieved by prone or upright positioning, and will not be relieved with corticosteroids or epinephrine, unlike croup. Diagnosis requires a high degree of clinical suspicion and can be confirmed with barium contrast esophagogram for those with esophageal symptoms, bronchoscopy, or CT or MRI.<ref name="pmid17034866">{{Cite journal|vauthors=Shah R, Mora B, Bacha E, Sena L, Buonomo C, Del Nido P, Rahbar R|title=The presentation and management of vascular rings: an otolaryngology perspective |journal=Int. J. Pediatr. Otorhinolaryngol. |volume=71 |issue=1 |pages=57–62 |date=Oct 2006 |doi=10.1016/j.ijporl.2006.08.025|pmid=17034866}}</ref>
==Treatment== It is sometimes treated with surgery.<ref name="pmid12677561">{{Cite journal|vauthors=Bonnard A, Auber F, Fourcade L, Marchac V, Emond S, Révillon Y |title=Vascular ring abnormalities: a retrospective study of 62 cases |journal=J. Pediatr. Surg. |volume=38 |issue=4 |pages=539–43 |date=April 2003 |pmid=12677561 |doi=10.1053/jpsu.2003.50117 }}</ref>
==References== {{Reflist}}
== External links == {{Medical resources | DiseasesDB = | ICD10 = {{ICD10|Q|25|4|q|20}} | ICD9 = {{ICD9|747.21}} | ICDO = | OMIM = | MedlinePlus = 007318 | eMedicineSubj = med | eMedicineTopic = 2981 | MeshID = }} {{Congenital vascular defects}}
Category:Congenital vascular defects