Kommerell diverticulum

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.

Clinical presentation

Kommerell diverticulum may be asymptomatic, or cause symptoms of oesophageal or tracheal obstruction.  

Radiographic features

Plain radiograph

On chest radiographs, a small rounded density may be seen laterally towards the left of the trachea.

Fluoroscopy

On barium swallow, an impression can be seen from left side of oesophagus simulating a double aortic arch.

CT/MRI

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

Complications

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).


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Article Information

rID: 9018
Section: Anatomy
Synonyms or Alternate Spellings:
  • Diverticulum of Kommerell
  • Kommerell's diverticulum
  • Kommerell diverticula
  • Kommerell's diverticula

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    Aberrant subclavi...
    Case 1
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    CE-MRA rotating f...
    Case 2: CE-MRA
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    Coronal MIP
    Case 3: setting of a right sided aortic arch
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    Case 4: with right arch + aberrant left subclavian
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     Case 5
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    Case 6: with aberrant right subclavian artery
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    Case 7
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    Case 8: hybrid treatment
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