Kommerell diverticula occur in some anomalies of the aortic arch system. It usually refers to the bulbous configuration of the origin of an aberrant left subclavian artery in the setting of a right sided aortic arch. However, it was originally described as a diverticular outpouching at the origin of an aberrant right subclavian artery with a left sided aortic arch.
Kommerell diverticulum may be asymptomatic, or cause symptoms of oesophageal or tracheal obstruction.
On chest radiographs, a small rounded density may be seen laterally towards the left of the trachea.
On barium swallow, an impression can be seen from left side of oesophagus simulating a double aortic arch.
Typically shows bulbous enlargement of the proximal subclavian artery at its origin from the aortic arch, posterior to the oesophagus.
Treatment and prognosis
Given the rarity of this condition, there is no established management guideline. Options include aortic replacement or thoracic endovascular stent-graft replacement (TEVAR), and extra-anatomic bypass of the aberrant subclavian artery 6,7.
The major complications of Kommerell diverticulum are rupture or dissection 7.
History and etymology
It is named after Burckhard F Kommerell, German radiologist (1901-1990).
- acute aortic syndrome
- thoracic aortic aneurysm
- abdominal aortic aneurysm
- endovascular aneurysm repair (EVAR)
- reporting tips for aortic aneurysms
- aortic coarctation
- aortic pseudocoarctation
- cervical aortic arch
- interrupted aortic arch
- transposition of the great arteries
- variant anatomy of the aortic arch
- traumatic aortic injuries
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- 6. Ota T, Okada K, Takanashi S et-al. Surgical treatment for Kommerell's diverticulum. J. Thorac. Cardiovasc. Surg. 2006;131 (3): 574-8. doi:10.1016/j.jtcvs.2005.10.012 - Pubmed citation
- 7. Knepper J, Criado E. Surgical treatment of Kommerell's diverticulum and other saccular arch aneurysms. J. Vasc. Surg. 2013;57 (4): 951-4. doi:10.1016/j.jvs.2012.10.094 - Pubmed citation