Journal of Clinical Gastroenterology and Hepatology Open Access

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Kissing carotids

Muhammad Shahbaz

A 70-year-old lady presented to the Emergency Department of Conquest Hospital with a decade long history of slowly progressive dysphagia getting worse over the last one year. Dysphagia was predominately for solids associated with episodes of vomiting, which usually comes on 2-3 minutes after having a meal. She was offered diagnostic Oesophago-Gastro-Duodenoscopy (OGD), but it was declined initially. Later on, she agreed to have upper GI endoscopy done, and it was decided that the procedure would be performed with paediatric scope. However, during intubation, she withdrew her consent and requested to stop the procedure since she was unable to tolerate it. She underwent Barium swallow which was remarkable for oesophageal indentations at C5, C6 junction due to aberrant course of carotids, coming in close proximity to the midline compressing onto the oesophagus, and causing dysphagia. Computed tomography of her chest confirmed altered course of the carotids coming in proximity at the midline, called “Kissing Carotids” compressing the thyroglossal duct on to the oesophagus posteriorly causing dysphagia. On that account, we highly suggest that kissing carotids should be considered a potential rare cause of dysphagia in patients presenting with progressive dysphagia of longer duration with solids especially where no other oesophageal pathology is found.