89 results on '"Diverticulum, Esophageal diagnostic imaging"'
Search Results
2. Symptomatic Epiphrenic Diverticulum in an Older Patient Successfully Treated Nonsurgically.
- Author
-
Kishioka A, Ochiai Y, Kikuchi D, and Hoteya S
- Subjects
- Humans, Female, Aged, 80 and over, Tomography, X-Ray Computed, Treatment Outcome, Endoscopy, Digestive System, Conservative Treatment, Diverticulum, Esophageal complications, Diverticulum, Esophageal diagnostic imaging, Diverticulum, Esophageal diagnosis, Diverticulum, Esophageal surgery, Deglutition Disorders etiology
- Abstract
Epiphrenic diverticulum is a rare condition commonly diagnosed in middle-aged adults. Symptoms include dysphagia and regurgitation, which are associated with underlying esophageal motility disorders. We herein report a 93-year-old woman with dysphagia diagnosed with symptomatic epiphrenic diverticulum by computed tomography, esophagogastroduodenoscopy, and esophagography. The patient was successfully treated non-surgically without any complications. This case demonstrates that conservative treatment is an option for older high-risk patients.
- Published
- 2024
- Full Text
- View/download PDF
3. An Unusual Case of Refractory Esophagitis and Esophageal Diverticulum.
- Author
-
Singh AD and Kurin M
- Subjects
- Female, Humans, Esophagoscopy, Aged, Diverticulum, Esophageal complications, Diverticulum, Esophageal diagnosis, Diverticulum, Esophageal diagnostic imaging, Esophagitis diagnosis, Esophagitis pathology, Esophagitis complications
- Published
- 2024
- Full Text
- View/download PDF
4. MSCT study for adult esophageal diverticulum with secondary broncho-esophageal fistula.
- Author
-
Dong X, Pan R, Duan L, Lu X, and Cao D
- Subjects
- Adult, Humans, Male, Female, Middle Aged, Retrospective Studies, Cohort Studies, Diverticulum, Esophageal diagnosis, Diverticulum, Esophageal diagnostic imaging, Esophageal Fistula diagnostic imaging, Esophageal Fistula etiology, Bronchial Fistula diagnostic imaging, Bronchial Fistula etiology, Bronchial Fistula surgery
- Abstract
Background: Broncho-esophageal fistula (BEF) secondary to esophageal diverticulum is a rare clinical condition, which is often misdiagnosed for a long time. The aim of our study is to summarize and clarify the advantages of MSCT in diagnosing BEF secondary to esophageal diverticulum., Methods: We retrospectively analyzed patients clinically diagnosed with BEF from January 2005 to January 2022 at Jilin University First Hospital. Only those patients with BEF secondary to esophageal diverticulum and complete clinical data met our enrolled standard. All patients' clinicopathologic characteristics and MSCT features were systemically evaluated., Results: 17 patients were eligible for our cohort study, including male 10 and female 7. The patient's mean age was 42.3 ± 12.5. The chronic cough occurred in all seventeen patients and bucking following oral fluid intake was documented in nine patients. MSCT distinctly suggested the fistulous tract between the bronchi and the esophagus in all patients. The mean diameter of the orifices in the wall of the esophagus was 4.40 ± 1.81 mm. The orifice in the midthoracic esophagus side was 15 cases and 2 cases at the lower thoracic esophagus. The involved bronchus included 13 cases at the right lower lobe bronchus, 1 at the right middle lobe bronchus and 3 at the left lower lobe bronchus. The contrast agent was observed in the pulmonary parenchyma in 10 of 13 patients who underwent esophagogram. No definite fistula was observed in 3 of 11 who underwent gastroscopy, while the intra-operative findings supported the existence of fistula., Conclusions: BEF secondary to esophageal diverticulum tends to occur between the midthoracic esophagus and the right lower lobe bronchus. Compared with esophagography and gastroscopy, MSCT shows more comprehensive information about the fistulous shape, size, course and lung involvement, which are helpful for establishing diagnosis and guiding subsequent treatment., (© 2024. The Author(s).)
- Published
- 2024
- Full Text
- View/download PDF
5. Esophageal intramural pseudodiverticulosis.
- Author
-
Shintaku M
- Subjects
- Middle Aged, Humans, Mucous Membrane pathology, Diverticulum, Esophageal complications, Diverticulum, Esophageal diagnostic imaging, Diverticulum, Esophageal epidemiology, Deglutition Disorders etiology, Diverticulum complications, Esophageal Stenosis therapy
- Abstract
Esophageal intramural pseudodiverticulosis (EIPD) is a disease of unknown pathogenesis characterized by usually systemic, cystic dilatation of the excretory ducts of esophageal submucosal glands. In this article, I review the epidemiology, clinical manifestations, endoscopic findings, esophagographic findings, and histopathology of EIPD. I also discuss the etiology and possible pathogenesis of EIPD based on my experiences with this disease and a review of the literature. EIPD usually presents with dysphagia in middle-aged individuals. It is often complicated with secondary infections, most commonly candidiasis. On esophagography, EIPD is delineated as small, multiple, flask-shaped outward projections within the esophageal wall. In recent years, EIPD has been mainly diagnosed by endoscopic findings of multiple, localized, small mucosal depressions. The orifices of the "pseudodiverticula" periodically open and close, and excrete mucus onto the mucosal surface. On histopathological examination, the luminal surface of dilated ducts in EIPD is covered by multilayered, hyperplastic epithelial cells, but myoepithelial cells in the glandular acini are well preserved. Treatment of EIPD is usually symptomatic therapy, and prevention of the infectious complications is important. The etiology and pathogenesis of EIPD are largely unknown, but functional abnormalities of autonomic nerve fibers innervating the esophageal glands likely play an important role, since the structures of the glands are basically preserved in this disease., Competing Interests: Conflict-of-interest statement: The author declares no conflict of interest related to this article., (©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.)
- Published
- 2024
- Full Text
- View/download PDF
6. Multiple Esophageal Diverticula in Achalasia.
- Author
-
Kamboj AK, Chan A, and Codipilly DC
- Subjects
- Humans, Esophageal Achalasia diagnosis, Esophageal Achalasia diagnostic imaging, Diverticulum, Esophageal diagnosis, Diverticulum, Esophageal diagnostic imaging
- Published
- 2024
- Full Text
- View/download PDF
7. Diverticular peroral endoscopic myotomy: management of a complex epiphrenic diverticulum.
- Author
-
Gaber A, Fadloon I, and Shehab H
- Subjects
- Humans, Treatment Outcome, Diverticulum, Esophageal diagnostic imaging, Diverticulum, Esophageal surgery, Diverticulum, Myotomy, Zenker Diverticulum, Natural Orifice Endoscopic Surgery, Esophageal Achalasia diagnosis, Esophageal Achalasia surgery
- Abstract
Competing Interests: The authors declare that they have no conflict of interest.
- Published
- 2023
- Full Text
- View/download PDF
8. Peroral endoscopic myotomy to treat epiphrenic diverticulum: a step-by-step video demonstration.
- Author
-
Papaefthymiou A, Norton B, Telese A, Aslam N, Sehgal V, and Haidry R
- Subjects
- Humans, Treatment Outcome, Diverticulum, Esophageal diagnostic imaging, Diverticulum, Esophageal surgery, Digestive System Surgical Procedures, Myotomy, Zenker Diverticulum, Esophageal Achalasia surgery
- Abstract
Competing Interests: The authors declare that they have no conflict of interest.
- Published
- 2023
- Full Text
- View/download PDF
9. Large symptomatic esophageal diverticulum.
- Author
-
Aguirre Sánchez-Cambronero JA, Rodríguez-Bobada Caraballo D, Martínez Flores C, and Sánchez-Manjavacas Muñoz N
- Subjects
- Female, Humans, Aged, Manometry, Esophageal Achalasia diagnosis, Diverticulum, Esophageal diagnostic imaging, Diverticulum, Esophageal surgery, Gastroesophageal Reflux complications, Diverticulum complications
- Abstract
A 72-year-old woman was referred from primary care to the gastroenterology clinic because of heartburn and occasional dysphagia for the last 8 years, with some isolated food regurgitation events and no other warning signs; she is currently asymptomatic on omeprazole. Gastroscopy revealed a dilated esophagus and food remnants with inability to reach the gastric lumen, which led to the suspicion of achalasia. The study was completed with pH-metry, which found no pathological reflux; esophageal manometry, with absence of esophageal motor abnormalities; and barium swallow, which revealed a large diverticulum on the posterior wall of the lower third of the esophagus, which had food remnants but no other changes or evidence of achalasia. Given these findings, a repeat gastroscopy was carried out that revealed a large diverticulum in the distal third of the esophagus that occluded 50 % of the esophageal lumen, with a length of 4-5 cm and abundant semi-liquid food remnants; upon aspiration of the latter a whitish mucosa with erythematous areas was revealed, as well as a 1.5-cm sliding hiatal hernia. No changes were found on advancing to the second duodenal portion. In view of the above findings and symptoms, the patient was referred to the surgery department to be evaluated for diverticulectomy.
- Published
- 2023
- Full Text
- View/download PDF
10. Epiphrenic esophageal diverticulum: an uncommon cause of upper gastrointestinal bleeding.
- Author
-
Kim SY
- Subjects
- Humans, Gastrointestinal Hemorrhage diagnostic imaging, Gastrointestinal Hemorrhage etiology, Diverticulum, Esophageal diagnosis, Diverticulum, Esophageal diagnostic imaging, Laparoscopy adverse effects
- Published
- 2023
- Full Text
- View/download PDF
11. Thoracoscopic approach as surgical management of esophageal epiphrenic diverticulum.
- Author
-
Boutron C, Rebibo L, Duboc H, Antonopulos C, Calabrese D, Coffin B, and Msika S
- Subjects
- Humans, Esophagus surgery, Fundoplication, Retrospective Studies, Diverticulum, Esophageal diagnostic imaging, Diverticulum, Esophageal surgery, Laparoscopy
- Abstract
Background: Management of diverticulum of the lower esophagus or epiphrenic diverticulum can be performed using the abdominal or thoracic approach. In some cases, the thoracic approach is preferred, but few studies have described thoracoscopic resection. The objective of the present study was to investigate the thoracoscopic approach for management of epiphrenic esophageal diverticulum., Material and Methods: From 2008 to 2018, all patients undergoing surgery for epiphrenic esophageal diverticulum by the thoracoscopic approach were included in this single-center, retrospective, observational study. Data on diverticulum, surgery and follow-up were assessed., Results: During the study period, 14 patients underwent surgery. Two patients had two diverticula. The mean location of the superior edge of the diverticulum was 7cm (2-14cm) above the gastro-esophageal junction. The mean size of the diverticulum was 39 millimeters (20-60). Thoracoscopic approach was used in all patients. No conversion to thoracotomy was required. Mean operative time was 168min (120-240). No postoperative mortality occurred. The overall complication rate was 40% (6 complications out of 15 resections), with three major complications including leaks (n=2) and a case of bronchoesophageal fistula (n=1). Median length of hospital stay was 12 days (8-40). At a mean postoperative follow-up of 20.7 months (5-71), 85% of patients had complete disappearance of preoperative symptoms without recurrence of the diverticulum on the barium swallow study test., Conclusion: Thoracoscopic approach as management of epiphrenic diverticulum is feasible, with acceptable short-term morbidity. The thoracoscopic approach is also effective in resolving preoperative symptoms., (Copyright © 2023 Elsevier Masson SAS. All rights reserved.)
- Published
- 2023
- Full Text
- View/download PDF
12. A superficial esophageal cancer with a diverticulum cured by endoscopic submucosal dissection.
- Author
-
Zhang Y, Ji L, An F, Zhu X, Zhou Z, Zhan Q, and Zhang G
- Subjects
- Humans, Esophagoscopy, Treatment Outcome, Retrospective Studies, Endoscopic Mucosal Resection, Esophageal Neoplasms complications, Esophageal Neoplasms diagnostic imaging, Esophageal Neoplasms surgery, Carcinoma, Squamous Cell, Diverticulum, Esophageal complications, Diverticulum, Esophageal diagnostic imaging, Diverticulum, Esophageal surgery
- Abstract
Esophageal diverticulum are rare. However, Esophageal cancer that involves diverticula is relatively rare. Here we reported a rare case of a superficial esophageal cancer with an esophageal diverticulum, which was invisible before the endoscopic submucosal dissection. The cancer was successfully removed by ESD with no perforation.
- Published
- 2023
- Full Text
- View/download PDF
13. Optimal surgical approaches for esophageal epiphrenic diverticulum: literature review and our experience.
- Author
-
Sato Y, Tanaka Y, Ohno S, Endo M, Okumura N, Takahashi T, and Matsuhashi N
- Subjects
- Humans, Fundoplication methods, Diverticulum, Esophageal diagnostic imaging, Diverticulum, Esophageal surgery, Esophageal Achalasia diagnostic imaging, Esophageal Achalasia surgery, Esophageal Motility Disorders surgery, Diverticulum surgery, Laparoscopy methods
- Abstract
Esophageal epiphrenic diverticulum is a rare condition usually secondary to a primary esophageal motility disorder. Although epiphrenic diverticulum may be treated by thoracoscopic and laparoscopic management, the optimal surgical approach have not been established. We successfully treated a left epiphrenic diverticulum along with achalasia and paraesophageal hernia by a planned combination of thoracoscopic and laparoscopic procedures aided by preoperative simulation using three-dimensional imaging. We reviewed a series of 17 reports on esophageal epiphrenic diverticulum that required either planned or unplanned unexpected transthoracic surgery. The main reasons for requiring a transthoracic approach were adhesions, site and size of the diverticulum, and length of the diverticulum neck. Unplanned procedure changes were required in 12 of the 114 cases for a conversion rate of 10.5%. Diverticulectomy, myotomy, and fundoplication were the most common surgical treatments administered at 42.6%. Based on literature review and our experience, we have developed a flowchart to identify the characteristics of epiphrenic diverticulum cases that require a transthoracic approach. This flowchart can help to determine therapeutic strategies and the optimal surgical approach to esophageal epiphrenic diverticulum treatment and may reduce unplanned changes in the surgery., (© 2023. The Author(s).)
- Published
- 2023
- Full Text
- View/download PDF
14. Esophageal Intramural Pseudodiverticulosis Diagnosed by Combining Esophagogastroduodenoscopy, Esophagography, and High-resolution Manometry.
- Author
-
Kunimitsu A, Ujiie N, Sato C, Taniyama Y, Okamoto H, Fukutomi T, Ozawa Y, Ohnuma S, Unno M, and Kamei T
- Subjects
- Male, Humans, Aged, Endoscopy, Digestive System, Manometry, Deglutition Disorders diagnosis, Deglutition Disorders etiology, Diverticulum, Esophageal diagnostic imaging, Esophageal Stenosis therapy, Esophagitis
- Abstract
Esophageal intramural pseudodiverticulosis (EIPD) is a rare disease. A 78-year-old man with dysphagia presented to our hospital. The presence of diffuse esophageal spasm was suspected by his primary-care doctor. High-resolution manometry (HRM) showed no abnormal findings. The patient was diagnosed with EIPD and Candida esophagitis, by esophagogastroduodenoscopy (EGD) and esophagography. His symptoms improved after symptomatic treatment for Candida esophagitis with oral administration of an antifungal drug. EIPD should be considered in patients with dysphagia; EGD and esophagography should be performed when diagnosing EIPD.
- Published
- 2023
- Full Text
- View/download PDF
15. Over-The-Scope clip closure of an acquired bronchoesophageal fistula secondary to an esophageal diverticulum.
- Author
-
Argüelles Estrada P, Fernández Cadenas F, Giganto Tomé F, Lamas Álvarez S, López Mourelle A, and Fraile López M
- Subjects
- Aged, Female, Humans, Endoscopy, Tomography, X-Ray Computed, Treatment Outcome, Bronchial Fistula diagnostic imaging, Bronchial Fistula etiology, Bronchial Fistula surgery, Esophageal Fistula diagnostic imaging, Esophageal Fistula etiology, Esophageal Fistula surgery, Self Expandable Metallic Stents adverse effects, Diverticulum, Esophageal complications, Diverticulum, Esophageal diagnostic imaging, Diverticulum, Esophageal surgery
- Abstract
Esophagorespiratory fistula is a rare entity that occurs as a result of malignant and non-malignant causes. This condition is associated with high morbidity and mortality. Surgical repair has traditionally been the most common treatment and self-expandable metal stent are the first choice among non-surgical techniques. Here, we report a non-malignant bronchoesophageal fistula secondary to an esophageal diverticulum that was successfully closed using an over-the-scope clip.
- Published
- 2023
- Full Text
- View/download PDF
16. Magnet-Assisted Diverticuloplasty in the Treatment of a Large Epiphrenic Esophageal Diverticulum.
- Author
-
Liu R, Yuan X, Zeng X, and Hu B
- Subjects
- Humans, Magnets, Fundoplication, Diverticulum, Esophageal diagnostic imaging, Diverticulum, Esophageal surgery, Laparoscopy
- Published
- 2023
- Full Text
- View/download PDF
17. Giant esophageal diverticulum: A case report and literature review.
- Author
-
Lv W, Li B, Li Z, and Zhang X
- Subjects
- Humans, Tomography, X-Ray Computed, Diverticulum, Esophageal diagnostic imaging, Diverticulum, Esophageal surgery
- Abstract
Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
- Published
- 2023
- Full Text
- View/download PDF
18. Benefits of laparoscopic trans-hiatal approach with Heller-Dor surgery in a case of mid-esophageal diverticulum.
- Author
-
Ueno S, Ogawa R, Saito M, Ito S, Hayakawa S, Okubo T, Sagawa H, Tanaka T, Takahashi H, Matsuo Y, Mitsui A, Kimura M, and Takiguchi S
- Subjects
- Humans, Treatment Outcome, Esophagus surgery, Fundoplication methods, Diverticulum, Esophageal diagnostic imaging, Diverticulum, Esophageal surgery, Laparoscopy methods
- Abstract
Compared to the more common epiphrenic diverticula, those located at the central section of the esophagus are quite rare. Minimally invasive approaches for mid-esophageal diverticula have lacked standardization. Certain mid-esophageal diverticula, like epiphrenic diverticula, have been attributed to esophageal motility disorders. Thus, we believe that surgery for esophageal diverticula requires preoperative evaluation of esophageal function, with additional surgery being performed in case of abnormalities. The laparoscopic trans-hiatal approach has been a common technique for managing epiphrenic diverticula but can also be used for mid-esophageal diverticula located far from the esophagogastric junction provided that the port location is carefully considered. Laparoscopic surgery is also preferable given that it is a minimally invasive procedure and allows for diverticulum resection and Heller myotomy and Dor surgery to prevent reflux in the same field of view. Hence, laparoscopic surgery may be a beneficial alternative to the traditional thoracic or thoracoabdominal techniques., (© 2022 Asia Endosurgery Task Force and Japan Society of Endoscopic Surgery and John Wiley & Sons Australia, Ltd.)
- Published
- 2023
- Full Text
- View/download PDF
19. Near-infrared fluorescence-assisted thoracoscopic diverticulectomy of esophageal diverticulum: a case report.
- Author
-
Xu H, Guan T, Fan R, Yang F, Li Y, and Zhou J
- Subjects
- Female, Humans, Middle Aged, Fluorescence, Indocyanine Green, Diverticulum, Esophageal diagnostic imaging, Diverticulum, Esophageal surgery, Diverticulum diagnostic imaging, Diverticulum surgery, Laparoscopy methods
- Abstract
Background: Esophageal diverticulum is a rare condition that requires treatment only when symptoms are present. Surgery has been considered to be the only curative option for symptomatic cases. The most popular procedure is diverticulectomy. Clear and intact exposure of the diverticulum's neck is the basis for safe and effective diverticulectomy., Case Presentation: We herein report a case of a 57 year-old woman with an epiphrenic diverticulum. VATS diverticulectomy was scheduled. To better identify the diverticulum neck, we injected indocyanine green (ICG) into the diverticulum through the endoscopic channel, and the diverticulum wall and neck were clearly visible under near-infrared (NIR) fluorescence. With the help of this method, diverticulectomy was successfully performed., Conclusion: This case shows that NIR fluorescence with ICG is safe, simple and reliable and can be used for diverticulectomy., (© 2023. The Author(s).)
- Published
- 2023
- Full Text
- View/download PDF
20. Congenital esophageal diverticulum with bronchoesophageal fistula treated with diverticular peroral endoscopic myotomy.
- Author
-
Wang Y, Mi J, and Zhao D
- Subjects
- Humans, Treatment Outcome, Diverticulum, Esophageal diagnostic imaging, Diverticulum, Esophageal surgery, Diverticulum, Esophageal Fistula, Bronchial Fistula diagnostic imaging, Bronchial Fistula etiology, Bronchial Fistula surgery, Myotomy, Esophageal Achalasia, Natural Orifice Endoscopic Surgery
- Published
- 2023
- Full Text
- View/download PDF
21. Peroral endoscopic myotomy for multiple esophageal diverticula.
- Author
-
Quan YS, Yao J, and Wang LS
- Subjects
- Humans, Esophagus, Treatment Outcome, Esophageal Sphincter, Lower, Diverticulum, Esophageal diagnostic imaging, Diverticulum, Esophageal surgery, Myotomy, Esophageal Achalasia, Natural Orifice Endoscopic Surgery
- Abstract
Competing Interests: The authors declare that they have no conflict of interest.
- Published
- 2022
- Full Text
- View/download PDF
22. Thoracoscopic resection of esophageal diverticulum assisted by white light under ICG mode.
- Author
-
Baeza Carrión A, Martínez Núñez S, Alarcón Del Agua I, and Morales-Conde S
- Subjects
- Humans, Thoracoscopy, Diverticulum, Esophageal diagnostic imaging, Diverticulum, Esophageal surgery
- Published
- 2022
- Full Text
- View/download PDF
23. Treatment of Achalasia and Epiphrenic Diverticulum.
- Author
-
Nadaleto BF, Herbella FAM, and Patti MG
- Subjects
- Barium, Fundoplication methods, Humans, Treatment Outcome, Diverticulum, Esophageal diagnosis, Diverticulum, Esophageal diagnostic imaging, Esophageal Achalasia diagnosis, Esophageal Achalasia surgery, Heller Myotomy, Laparoscopy
- Abstract
Background: Epiphrenic diverticulum (ED) is a pulsion pseudodiverticulum found in the distal 10 cm of the esophagus. Motility disorders are present in the majority of patients with ED explaining the pathophysiology of this rare disease. Achalasia is the most common underlying disorder. We present a review on the diagnosis and management of ED in the setting of achalasia., Methods: Literature review., Results: Symptoms are most related to the underlying motility disorder. The diagnostic workup should always include an upper digestive endoscopy and a barium esophagogram. Esophageal manometry identifies the motility disorder in most patients. Therapeutic options include laparoscopic, thoracoscopic and endoscopic procedures. While a myotomy must always be performed, diverticulectomy is not always necessary., Conclusions: Epiphrenic diverticulum is a rare condition whose pathophysiology involves an underlying motility disorder-achalasia in most cases. Symptoms usually include dysphagia, regurgitation, heartburn, and respiratory complaints and correlate with the motility disorder rather than the diverticulum per se. Upper digestive endoscopy and barium esophagogram are needed for the diagnosis-manometry may add useful information but is not imperative for the treatment. Laparoscopic Heller myotomy with a partial fundoplication is the procedure of choice, with satisfactory symptom relief and several advantages over the thoracic approach. Diverticulectomy may be performed in selected patients. Peroral endoscopic myotomy (POEM) are novel techniques, effective and minimally invasive that can be an option for patients unfit for surgery., (© 2022. The Author(s) under exclusive licence to Société Internationale de Chirurgie.)
- Published
- 2022
- Full Text
- View/download PDF
24. Congenital true oesophageal diverticulum: a report and review of the literature.
- Author
-
Prasad G, Jain V, Goel P, and Agarwala S
- Subjects
- Humans, Infant, Male, Deglutition Disorders etiology, Diverticulum, Diverticulum, Esophageal diagnosis, Diverticulum, Esophageal diagnostic imaging, Gastroesophageal Reflux complications, Gastroesophageal Reflux surgery
- Abstract
Oesophageal diverticulum occurring secondary to motility disorders or gastro-oesophageal reflux disease (GERD) is common in adults but true congenital oesophageal diverticula are rare in infants and children. We present a case of a toddler boy who presented with dysphagia and vomiting after feeds after weaning was attempted starting at 6 months of age. Barium esophagogram revealed a diverticulum in the upper one-third of the oesophagus within the thoracic cavity. The child underwent multiple interventions elsewhere without definitive surgery that highlights the rarity of this condition. Thoracotomy and repair were performed by us with a satisfactory outcome. The review of the literature on the clinical presentation and management of this rare condition has been discussed, highlighting similar reported cases., Competing Interests: Competing interests: None declared., (© BMJ Publishing Group Limited 2022. No commercial re-use. See rights and permissions. Published by BMJ.)
- Published
- 2022
- Full Text
- View/download PDF
25. [Update Esophageal Diverticula].
- Author
-
Gutschow C
- Subjects
- Humans, Diverticulum complications, Diverticulum, Esophageal diagnostic imaging, Diverticulum, Esophageal surgery, Zenker Diverticulum diagnostic imaging, Zenker Diverticulum surgery
- Abstract
Update Esophageal Diverticula Abstract. Esophageal diverticula are rare diseases typically associated pathophysiologically with esophageal dysmotility. The most common location (about 80%) is pharyngo-oesophageal. The therapy must be adapted to the location, the size, the symptoms and also the individual perioperative risk of the patient. In this context, following Herbella et al. [1] summarize that a) asymptomatic diverticula do not require therapy; b) small (< 1cm) diverticula do not usually need to be resected; c) medium-sized (1-3cm) and large (> 4cm) diverticula should be treated either by resection, pex, invagination or (for Zenker's diverticulum) by transoral diverticulo-esophagostomy, and d) a simultaneous myotomy should always be performed. Due to the rarity of esophageal diverticula and due to the wide range of therapeutic options, the expertise required for an individual therapy concept is often not available even in larger clinics, which is why we recommend treatment in a reference center. In our opinion, the counseling and treatment of patients with esophageal diverticula by an experienced interdisciplinary team using all the options of today's established endoscopic and surgical procedures is the prerequisite for a low-complication management of this unusual clinical picture.
- Published
- 2022
- Full Text
- View/download PDF
26. Laparoscopic trans-hiatal approach in a rare case of double giant epiphrenic diverticula: A case report.
- Author
-
Wangkulangkul P, Laohawiriyakamol S, and Chewatanakornkul S
- Subjects
- Aged, Fundoplication methods, Humans, Male, Manometry methods, Digestive System Surgical Procedures, Diverticulum, Esophageal diagnostic imaging, Diverticulum, Esophageal surgery, Laparoscopy methods
- Abstract
The transthoracic approach for esophageal diverticulectomy saves dissection but limits the amount of antireflux surgery that can be done. However, the laparoscopic trans-hiatal approach usually limits access to large diverticula located at the mid-thoracic level. We describe a 67-year-old Thai man who had two giant epiphrenic diverticula (ED) (11 × 7.6 cm and 3.2 × 3.4 cm). The highest part of the fundus of the larger ED was 12.6 cm above the hiatus. Preoperative esophageal manometry and an upper gastrointestinal study showed no obvious features of motility disorder. In addition, the clinical evaluation of the esophagogastroduodenoscopy revealed a hiatal hernia. Laparoscopic trans-hiatal esophageal diverticulectomy with intraoperative assessment by endoscopy was carried out. A partial wrap using Dor fundoplication was constructed without myotomy. There were no postoperative related complications. We believe that tailor-made operations in unusual cases can be safe using combined techniques to reduce postoperative morbidity., (© 2021 Asia Endosurgery Task Force and Japan Society of Endoscopic Surgery and John Wiley & Sons Australia, Ltd.)
- Published
- 2022
- Full Text
- View/download PDF
27. Esophageal Diverticulum - Indications and Efficacy of Therapeutic Endoscopy.
- Author
-
Sato H, Takeuchi M, Takahashi K, Mizuno KI, Furukawa K, Sato A, Nakajima N, Yokoyama J, and Terai S
- Subjects
- Esophageal Sphincter, Lower, Esophagoscopy methods, Humans, Diverticulum, Esophageal diagnostic imaging, Diverticulum, Esophageal surgery, Esophageal Achalasia etiology, Esophageal Motility Disorders diagnosis, Esophageal Motility Disorders surgery
- Abstract
Objective Esophageal diverticulum is rare, and the concomitance of esophageal motility disorders (EMDs) and the efficacy of novel endoscopic treatment have not been investigated in Japan. Methods An examination including high-resolution manometry (HRM) was performed for patients with both EMDs and epiphrenic diverticulum. EMD-related epiphrenic diverticulum and Zenker's diverticulum were treated using salvage peroral endoscopic myotomy (s-POEM) and endoscopic diverticulotomy, respectively. Results Six cases of epiphrenic diverticulum were diagnosed in this study. Among 125 patients with achalasia and spastic disorders, concomitant epiphrenic diverticulum was observed in 4 (3.2%). Of these, three showed a normal lower esophageal sphincter pressure on HRM, although gastroscopy and esophagography revealed typical findings of an impaired lower esophageal sphincter relaxation. These four patients were successfully treated with s-POEM, and the Eckardt score improved from 6.3 to 0.25 at 32.5 (range: 13-56) months of follow-up, with equivalent treatment efficacy to that observed for achalasia and spastic disorders without epiphrenic diverticulum. In contrast, the two remaining cases of epiphrenic diverticulum had normal esophageal motility. Six cases of Zenker's diverticulum were diagnosed, and endoscopic diverticulotomy was successfully performed in all. The dysphagia score decreased from 2.8 to 0.17 at 14.8 (range: 2-36) months of follow-up. Overall, 12 endoscopic treatments were performed for esophageal diverticulum; no adverse events were observed. Conclusion In epiphrenic diverticulum patients, concomitant EMDs are not rare and should be carefully diagnosed. A normal lower esophageal sphincter pressure on HRM does not always mean a normal lower esophageal sphincter relaxation. S-POEM and endoscopic diverticulotomy are effective minimally invasive treatment options for EMD-related epiphrenic diverticulum and Zenker's diverticulum.
- Published
- 2022
- Full Text
- View/download PDF
28. Treatment of Giant Esophageal Epiphrenic Diverticulum Using Robotic-Assisted Surgery.
- Author
-
Sommer R, Machado Grossi JV, Grossi Harada GR, Seabra MK, Cavazzola LT, and Seabra AP
- Subjects
- Aged, Fundoplication, Humans, Male, Diverticulum, Esophageal diagnostic imaging, Laparoscopy, Myotomy, Robotic Surgical Procedures
- Abstract
Epiphrenic diverticulum is a rare condition associated with esophageal motor disorder, and it is often asymptomatic, with a well-established surgical indication. The present study aims to report a case of a giant epiphrenic diverticulum in a 68-year-old male patient who, due to the symptoms, opted for surgical treatment using the daVinci® system. Robotic surgery consisting of esophageal diverticulectomy with cardiomyotomy was performed. The patient had an excellent recovery with an abbreviated hospitalization, return to food, and satisfactory routine activity., Competing Interests: Conflict of interests: none., (© 2022 by SLS, Society of Laparoscopic & Robotic Surgeons.)
- Published
- 2021
- Full Text
- View/download PDF
29. Surgical resection of voluminous epiphrenic diverticula.
- Author
-
Maertens V, Lagarde S, and Wijnhoven B
- Subjects
- Drainage, Esophagus surgery, Female, Fundoplication, Humans, Male, Thoracotomy, Diverticulum, Esophageal diagnostic imaging, Diverticulum, Esophageal surgery, Laparoscopy
- Abstract
A 52-year-old male and 55-year-old female underwent surgical resection of a voluminous symptomatic epiphrenic diverticulum via a right thoracotomy. A formal myotomy of the distal esophagus was not performed. The first patient had an uncomplicated recovery whilst the other patient still suffers from an esophageal-cutaneous fistula and repetitive abscesses, treated by intravenous antibiotics and percutaneous drainage. The authors discuss the indication for resection, surgical techniques and complications.
- Published
- 2021
- Full Text
- View/download PDF
30. Epiphrenic Diverticulum.
- Author
-
Lakhani DA, Hadi YB, and Smith M
- Subjects
- Humans, Deglutition Disorders, Diverticulum, Diverticulum, Esophageal diagnostic imaging, Diverticulum, Esophageal surgery, Laparoscopy
- Published
- 2021
- Full Text
- View/download PDF
31. Peroral endoscopic myotomy for the treatment of esophageal diverticulum: an experience in China.
- Author
-
Zeng X, Bai S, Zhang Y, Ye L, Yuan X, and Hu B
- Subjects
- Aged, Aged, 80 and over, China, Digestive System Surgical Procedures adverse effects, Diverticulum, Esophageal diagnostic imaging, Female, Humans, Male, Middle Aged, Myotomy adverse effects, Natural Orifice Endoscopic Surgery adverse effects, Operative Time, Postoperative Complications etiology, Retrospective Studies, Treatment Outcome, Digestive System Surgical Procedures methods, Diverticulum, Esophageal surgery, Myotomy methods, Natural Orifice Endoscopic Surgery methods
- Abstract
Background: With the development of minimally invasive endoscopic approaches for the esophagus in recent years, peroral endoscopic myotomy (POEM) in the treatment of esophageal diverticulum has been described recently in some reports due to its successful outcomes. The aim of this study is to report our experience with the use of diverticular POEM (D-POEM) technique in the management of esophageal diverticulum., Methods: This retrospective study included consecutive patients with symptomatic esophageal diverticulum who visited our endoscopy center between April 2014 and January 2019. D-POEM was performed based on the principles of submucosal endoscopy. A new symptomatic scoring system was introduced to evaluate the severity of diverticular symptoms., Results: A total of 10 patients with esophageal diverticulum (Zenker's 2, mid-esophagus 5, and epiphrenic 3) were included. The overall technical success rate of D-POEM was 100%, with a mean procedure time of 38.9 ± 20.5 (range 16-70) min. No serious complications occurred. Clinical improvement was achieved in 90% (9/10) of patients. The symptomatic score was significantly decreased from 2.5 (IQR 2.00-3.25) to 1.0 (IQR 0-1.25) (P = 0.007) during a median follow-up period of 11.0 (IQR 10.25-17.25) months., Conclusion: These findings suggested complete septotomy by D-POEM. Our preliminary data and experience put forwarded D-POEM as a safe and effective technique for esophageal diverticulum.
- Published
- 2021
- Full Text
- View/download PDF
32. Epiphrenic pulsion diverticulum: an uncommon cause of dysphagia and heartburn.
- Author
-
Qua CS, Saravannan K, and Goh KL
- Subjects
- Heartburn, Humans, Deglutition Disorders etiology, Diverticulum, Esophageal complications, Diverticulum, Esophageal diagnostic imaging, Diverticulum, Esophageal surgery, Laparoscopy
- Abstract
Competing Interests: Competing interests: None declared.
- Published
- 2021
- Full Text
- View/download PDF
33. 99mTc-Sestamibi Scintigraphy Reveals Parathyroid Adenoma Masquerading as Esophageal Diverticulum.
- Author
-
Kay MD, Morris-Wiseman LF, Caskey J, Winegar BA, and Kuo PH
- Subjects
- Aged, Diagnosis, Differential, Female, Humans, Magnetic Resonance Imaging, Diverticulum, Esophageal diagnostic imaging, Parathyroid Neoplasms diagnostic imaging, Single Photon Emission Computed Tomography Computed Tomography, Technetium Tc 99m Sestamibi
- Abstract
Abstract: A 74-year-old woman with primary hyperparathyroidism diagnosed from routine laboratory tests described symptoms of fatigue and difficulty with concentration. During surgical consultation, the cervical and thoracic spine MRI scans from the preceding 10-year period, performed for relapsing-remitting multiple sclerosis, were reviewed. In this clinical context, the slowly enlarging left upper paraesophageal lesion, reported as a lateral proximal esophageal (Killian-Jamieson) diverticulum, was reevaluated for a potential parathyroid adenoma. 99mTc-sestamibi SPECT/CT demonstrated focal uptake in the paraesophageal lesion with surgical resection, confirming it to be a large parathyroid adenoma., Competing Interests: Conflicts of interest and sources of funding: P.H.K. and M.D.K. are consultants to Invicro. P.H.K. is also a speaker for, consultant to, and recipient of grants from GE Healthcare. The remaining authors have none declared., (Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.)
- Published
- 2021
- Full Text
- View/download PDF
34. Commentary: Measure Twice, Cut Once: Understanding the Anatomy and Physiology of Esophageal Epiphrenic Diverticula Guides Optimal Surgical Management.
- Author
-
Gupta V and Darling G
- Subjects
- Esophagus diagnostic imaging, Esophagus surgery, Humans, Diverticulum, Esophageal diagnostic imaging, Diverticulum, Esophageal surgery
- Published
- 2021
- Full Text
- View/download PDF
35. Management of Epiphrenic Diverticula and Short-term Outcomes.
- Author
-
Sudarshan M, Fort MW, Barlow JM, Allen MS, Ravi K, Nichols F, Cassivi SD, Wigle DA, Shen RK, and Blackmon SH
- Subjects
- Fundoplication, Humans, Retrospective Studies, Diverticulum, Diverticulum, Esophageal diagnostic imaging, Diverticulum, Esophageal surgery, Laparoscopy
- Abstract
Epiphrenic diverticulum is a rare and benign condition with significant surgical morbidity and evolving surgical management. The objective of this study was to analyze short-term clinical outcomes after surgery for epiphrenic diverticula. We conducted a retrospective cohort study in a single tertiary care center of all patients who underwent treatment for epiphrenic esophageal diverticula from June 1990 to December 2016. Data collection included demographics, operative details and short-term outcomes (esophageal leak, other complications, 30-day mortality). In addition, all preoperative imaging was reviewed by an esophageal radiologist in order to describe epiphrenic diverticula characteristics in a uniform and blinded manner. Of the 94 patients in the study, 84 patients were managed with an open surgical approach and 10 with minimally invasive techniques. Median size of diverticula was 5.5 cm and mean height above gastroesophageal junction was 4 cm. A myotomy was completed in 95% of patients and a fundoplication in 58%. The MIS group had a shorter length of stay (4 vs 6 days). Overall complication rate was 27% with an esophageal leak rate of 7% with 60% grade I leaks that sealed with conservative management. Complete resection of the diverticulum, closure of the muscle over the resection, contralateral myotomy, and consideration for partial fundoplication are common strategies utilized to surgically treat patients with epiphrenic diverticulum. Minimally invasive approaches are increasingly utilized., (Copyright © 2020 Elsevier Inc. All rights reserved.)
- Published
- 2021
- Full Text
- View/download PDF
36. Commentary: Toward Minimally Invasive Management of Epiphrenic Diverticula.
- Author
-
Louie BE
- Subjects
- Humans, Thoracoscopy, Diverticulum, Esophageal diagnostic imaging, Diverticulum, Esophageal surgery
- Published
- 2021
- Full Text
- View/download PDF
37. Peroral endoscopic myotomy in a case of recurrent epiphrenic diverticulum after surgery.
- Author
-
Pizzicannella M, Spota A, Dallemagne B, Swanström L, Marescaux J, and Perretta S
- Subjects
- Aged, 80 and over, Humans, Male, Digestive System Surgical Procedures, Diverticulum, Esophageal diagnostic imaging, Diverticulum, Esophageal surgery, Esophageal Achalasia surgery, Myotomy
- Abstract
Competing Interests: Jacques Marescaux is the President of IRCAD, which is partly funded by Karl Storz, Siemens, and Medtronic. Lee Swanström consults for Medtronic, Boston Scientific, and Olympus.Margherita Pizzicannella, Silvana Perretta, Andrea Spota and Bernard Dallemagne have no conflict of interest to declare.
- Published
- 2021
- Full Text
- View/download PDF
38. Bronchoesophageal fistula secondary to esophageal diverticulum in an adult: a case report and literature review.
- Author
-
Zhang X, Jiao H, and Liu X
- Subjects
- Adult, Cough, Hemoptysis, Humans, Male, Middle Aged, Bronchial Fistula diagnostic imaging, Bronchial Fistula etiology, Bronchial Fistula surgery, Diverticulum, Esophageal complications, Diverticulum, Esophageal diagnostic imaging, Diverticulum, Esophageal surgery, Esophageal Fistula diagnostic imaging, Esophageal Fistula etiology, Esophageal Fistula surgery
- Abstract
Esophageal diverticulum with secondary bronchoesophageal fistula is a rare clinical entity that manifests as respiratory infections, coughing during eating or drinking, hemoptysis, and sometimes fatal complications. In the present study, we describe a case of bronchoesophageal fistula emanating from esophageal diverticulum in a 45-year-old man who presented with bronchiectasis. We summarize the characteristics of this rare condition based on a review of the relevant literature.
- Published
- 2021
- Full Text
- View/download PDF
39. Peroral endoscopic myotomy approach to treating a Killian-Jamieson diverticulum.
- Author
-
Wander P, Trindade A, and Benias PC
- Subjects
- Humans, Diverticulum, Diverticulum, Esophageal diagnostic imaging, Diverticulum, Esophageal surgery, Myotomy, Zenker Diverticulum
- Abstract
Competing Interests: P. C. Benias is a consultant for Medtronic, Boston Scientific, Apollo Endosurgical, and Olympus America. A. Trindade is a consultant for Pentax Medical and Olympus America. P. Wander declares no conflict of interest.
- Published
- 2020
- Full Text
- View/download PDF
40. Not always eosinophilic esophagitis - intramural pseudodiverticulosis of the esophagus - a case report and literature review.
- Author
-
Frieling T, Kreysel C, Blank M, Mülle D, Euler P, and Melchior I
- Subjects
- Dilatation, Diverticulum, Esophageal diagnostic imaging, Eosinophilic Esophagitis diagnosis, Eosinophilic Esophagitis therapy, Esophageal Stenosis complications, Esophageal Stenosis therapy, Female, Humans, Middle Aged, Deglutition Disorders etiology, Diverticulum, Esophageal complications, Endoscopy, Digestive System methods, Esophageal Stenosis diagnostic imaging, Esophagus diagnostic imaging
- Abstract
Background: Intramural pseudodiverticulosis of the esophagus (EIPD) is a rare disease leading to dysphagia, chest pain, and weight loss. The diagnosis is difficult, and the disease can be confounded with eosinophilic esophagitis (EoE). We present a patient with esophageal intramural pseudodiverticulosis and a literature review., Case Report: The 45-year-old white caucasian woman with a history of nicotine and alcohol abuse had progressive hoarseness and severe dysphagia for solid food. Esophagogastroduodenoscopy (EGD) showed proximal esophageal stenosis, thrush esophagitis, and mucosal alteration with trachealization suspicious of EoE. However, repeated bouginage EGD and barium swallow revealed typical signs of esophageal intramural pseudodiverticulosis (EIPD). The patient was treated successfully by bougingage, acid suppression, and antifungal therapy. The literature analysis revealed the characteristics of EIPD according to age, sex, risk factors, and therapy modalities., Conclusion: The case report and the literature overview suggest that EIPD can be confounded with EoE., Competing Interests: The authors declare that they have no conflict of interest., (Thieme. All rights reserved.)
- Published
- 2020
- Full Text
- View/download PDF
41. Gastrointestinal: A rare cause of upper gastrointestinal bleeding: Epiphrenic esophageal diverticula.
- Author
-
Sivanes S and Chang J
- Subjects
- Aged, 80 and over, Diagnosis, Differential, Diverticulum, Esophageal surgery, Endoscopy, Gastrointestinal, Esophagogastric Junction, Humans, Melena etiology, Tomography, X-Ray Computed, Diverticulum, Esophageal complications, Diverticulum, Esophageal diagnostic imaging, Gastrointestinal Hemorrhage etiology
- Published
- 2020
- Full Text
- View/download PDF
42. Visualization of Killian-Jamieson bilateral diverticulum in gastro-esophageal reflux scintigraphy with [ 99m Tc]Tc-nanocolloid.
- Author
-
Acuña Hernandez M, González Ramírez AI, and Morales Avellaneda T
- Subjects
- Aged, Deglutition, Diverticulum, Esophageal complications, Fluoroscopy, Gastroesophageal Reflux etiology, Humans, Video Recording, Diverticulum, Esophageal diagnostic imaging, Gastroesophageal Reflux diagnostic imaging, Nanoparticles, Radionuclide Imaging methods, Radiopharmaceuticals, Technetium Tc 99m Aggregated Albumin
- Published
- 2020
- Full Text
- View/download PDF
43. Concomitant esophageal intramural pseudodiverticulosis and eosinophilic esophagitis: a diagnosis that needs to be histologically proved.
- Author
-
Miranda García P, Casabona Francés S, and Santander Vaquero C
- Subjects
- Humans, Diverticulum, Esophageal diagnosis, Diverticulum, Esophageal diagnostic imaging, Eosinophilic Esophagitis complications, Eosinophilic Esophagitis diagnosis
- Published
- 2020
- Full Text
- View/download PDF
44. Laparoscopic surgery for ventrally located epiphrenic diverticulum with esophageal achalasia.
- Author
-
Ueda Y, Tsunoda S, Hisamori S, Hashimoto K, Nishigori T, Sakaguchi M, Obama K, and Sakai Y
- Subjects
- Fundoplication, Humans, Male, Middle Aged, Diverticulum, Esophageal complications, Diverticulum, Esophageal diagnostic imaging, Diverticulum, Esophageal surgery, Esophageal Achalasia complications, Esophageal Achalasia surgery, Esophageal Motility Disorders, Laparoscopy, Myotomy
- Abstract
Epiphrenic diverticulum is frequently associated with esophageal motility disorder, including esophageal achalasia. Heller's myotomy should accompany diverticulectomy to reduce the bulging pressure in surgery for epiphrenic diverticulum with esophageal achalasia. In such cases, designing myotomy is sometimes difficult, depending on the size and location of the diverticulum. Ventrally located diverticula require special caution to spare some muscular tissue between the longitudinal staple line of the diverticulectomy and myotomy, which is a crucial step to prevent staple-line dehiscence. In this article, we describe a case with ventrally located epiphrenic diverticulum who underwent successful laparoscopic resection and myotomy for esophageal achalasia with an informative surgical video.
- Published
- 2020
- Full Text
- View/download PDF
45. Advanced squamous cell carcinoma in an asymptomatic, large, epiphrenic esophageal diverticulum.
- Author
-
Yoshida T, Hashimoto S, Mizuno KI, Ichikawa H, Yokoyama J, Umezu H, and Terai S
- Subjects
- Esophagectomy, Humans, Male, Middle Aged, Neoplasm Recurrence, Local surgery, Carcinoma, Squamous Cell diagnostic imaging, Carcinoma, Squamous Cell surgery, Diverticulum, Esophageal diagnostic imaging, Diverticulum, Esophageal surgery, Esophageal Neoplasms surgery
- Abstract
An asymptomatic epiphrenic diverticulum (ED) was diagnosed in a man undergoing annual esophagogastroduodenoscopy (EGD) at another hospital 40 years before he presented to our hospital at age 63 years for his annual EGD. However, because substantial food retention was found in the ED, we could not confirm a lesion. After the retained food was removed endoscopically, a second EGD showed a reddish, flat lesion with an elevated mass within the ED. Endoscopic ultrasonography indicated that the elevated mass was deep in the submucosal layer. An esophagram showed that the ED was approximately 80 mm in diameter, which is considered large. An endoscopic biopsy of the lesion confirmed squamous cell carcinoma. Total esophagectomy was performed. Microscopic examination revealed well-differentiated to moderately differentiated squamous cell carcinoma invading the adventitia at the elevated lesion. The final pathological stage was pT3N0M0. There was no evidence of recurrence for 3 years during the quarterly follow-up examinations. To our knowledge, this case involved the longest asymptomatic term (40 years) since the ED was detected. A review of 18 reported cases of carcinoma in an ED indicated that advanced cancer has a poor prognosis. Periodic follow-up of ED patients is essential for early diagnosis.
- Published
- 2020
- Full Text
- View/download PDF
46. Incidental 18F-Fluorocholine Uptake in an Esophageal Diverticulum: 18F-FCH in an Esophageal Diverticulum.
- Author
-
Araz M, Cinel M, Soydal C, Ozkan E, and Kucuk NO
- Subjects
- Aged, Choline analogs & derivatives, Female, Humans, Radiopharmaceuticals, Diverticulum, Esophageal diagnostic imaging, Incidental Findings, Positron Emission Tomography Computed Tomography
- Abstract
F-fluorocholine has recently emerged as a very sensitive agent for seeking parathyroid adenomas. We represent a case with esophageal diverticulum incidentally detected on F-fuorocholine PET/CT, which should be kept in mind as a reason of false positivity in primary hyperparathyroidism.
- Published
- 2020
- Full Text
- View/download PDF
47. Oesophageal traction diverticulum resulting from pulmonary tuberculosis.
- Author
-
Khaitan PG and Watson TJ
- Subjects
- Esophagoscopy, Female, Gastroesophageal Reflux, Humans, Middle Aged, Radiography, Tomography, X-Ray Computed, Diverticulum, Esophageal diagnostic imaging, Diverticulum, Esophageal etiology, Tuberculosis, Pulmonary complications
- Abstract
Competing Interests: Competing interests: None declared.
- Published
- 2020
- Full Text
- View/download PDF
48. Current possibilities of minimally invasive therapy of oesophageal diverticula.
- Author
-
Stašek M, Neoral Č, Zhydkov R, Vrba R, and Aujeský R
- Subjects
- Humans, Quality of Life, Diverticulum, Esophageal diagnostic imaging, Diverticulum, Esophageal surgery, Gastroesophageal Reflux, Laparoscopy
- Abstract
Oesophageal diverticula represent a relatively rare pathology of the oesophagus requiring a specific diagnostic and therapeutic approach. Interventional therapy is indicated for symptomatic diverticula, diverticula with other pathologies (tumour in the diverticulum, gastroesophageal reflux disease, low-malignancy gastroesophageal junction tumours). The open surgical approach is being increasingly replaced by minimally invasive surgical, endoscopic and combined methods. Surgical mini-invasive methods use transaxillary, thoracoscopic or transhiatal laparoscopic approach, often with endoscopic assistance. Endoscopic and transoral surgical procedures include various diverticulotomy techniques and submucosal tunnelling techniques (variants of peroral endoscopic myotomy). The primary concern in therapy is the reduction of symptoms, improvement of the quality of life and the patient´s safety. The resulting quality of life is affected by the frequent presence of functional diseases of the oesophagus (achalasia, hypercontractile oesophagus). Although surgical minimally invasive therapy using the laparoscopic or thoracoscopic approach is safe, it nevertheless does not exclude serious risk of complications. Randomized and observational studies comparing endoscopic and surgical methods are still missing. It is, therefore, necessary to extend the records in order to update the indication algorithm of intervention therapy, focusing mainly on safety with a clear imperative for patient centralization.
- Published
- 2020
- Full Text
- View/download PDF
49. Endoscopic Transversal Incision and Longitudinal Septostomy (TILS): An Updated Technique for Treating Esophageal Diverticulum.
- Author
-
Hu H, Wang M, Zhu L, and Zhou P
- Subjects
- Diverticulum, Esophageal diagnostic imaging, Esophagus diagnostic imaging, Esophagus surgery, Female, Humans, Zenker Diverticulum diagnostic imaging, Zenker Diverticulum surgery, Diverticulum, Esophageal surgery, Esophagoscopy
- Abstract
An esophageal diverticulum is a protruding pouch in a weak portion of the esophageal lining. Previously, our team had reported an endoscopic tunneling technique (submucosal tunneling endoscopic septum division) for diverticulum treatment. However, it does not perform well for the diverticulum located in the upper esophagus, where most diverticula are located. Herein, we report a new endoscopic technique, called endoscopic transversal incision and longitudinal septostomy (TILS). TILS provides both larger operational spaces and complete septostomy and can be performed on most types of diverticula, including Zenker's diverticulum., (© 2020 S. Karger AG, Basel.)
- Published
- 2020
- Full Text
- View/download PDF
50. The oesophageal diverticulum of Dirioxa pornia studied through micro-CT scan, dissection and SEM studies.
- Author
-
Bhandari K, Crisp P, and Keller MA
- Subjects
- Animals, Bacteria classification, Diverticulum, Esophageal microbiology, Female, Imaging, Three-Dimensional, Male, Microscopy, Electron, Scanning, Sex Characteristics, Sexual Behavior, Animal, Tephritidae anatomy & histology, Tephritidae physiology, X-Ray Microtomography, Yeasts classification, Bacteria ultrastructure, Diverticulum, Esophageal diagnostic imaging, Tephritidae microbiology, Yeasts ultrastructure
- Abstract
Background: Dirioxa pornia (Diptera, Tephritidae) (Island fly) is an Australian native species related to a number of pestiferous fruit flies but, unlike many of the pest species, has not been studied extensively due to its non-pest status. However, due to D. pornia's apparent reliance on the bacteria for survival it is an ideal species to undertake studies into interaction between Tephritid species and bacteria associated with the intestinal tract. The oesophageal diverticulum, which is a blind-ended protrusion of the oesophagus, has been studied, described and characterised in many other Tephritid species. Unlike many other species where the oesophageal diverticulum has been observed the organ was only observed in male D. pornia. It is speculated that this sexual dimorphism the organ may be the primary location to host beneficial bacteria in the involved in the production of the nuptial gift and the mating success of this Tephritid species. In case of D. pornia, however, no study on any area of the digestive system has been conducted. This study was conducted to locate and characterize the oesophageal diverticulum in D. pornia. A virtual dissection of the alimentary tract was made through micro-computer tomography studies. These studies were followed by dissection and scanning microscopy studies to elucidate the presence of bacteria., Results: The oesophageal diverticulum of D. pornia is part of the foregut and distends from the oesophagus within the head of the fly. The shape of the oesophageal diverticulum corresponds with the Ceratitis type. Scanning microscopy studies of the oesophageal diverticulum show rod-shaped bacterial cells residing along with yeast cells in the lumen. The organ was only observed in male specimens., Conclusions: This study classifies the oesophageal diverticulum of D. pornia under the "Ceratitis type" of oesophageal diverticula in Tephritid species. The study also proves that micro-CT scanning is possible to locate soft tissues in Tephritid species and the Avizo® Fire software can be successfully used to visualize 3 dimensional (3D) images from x-rays. The methods used in this experiment can be used in future studies for visualising soft tissues of adult Tephritid species through micro tomography. There is sexual dimorphism with the organ only found in males. Finally this study shows that bacteria are present in the oesophageal diverticulum of D. pornia.
- Published
- 2019
- Full Text
- View/download PDF
Catalog
Discovery Service for Jio Institute Digital Library
For full access to our library's resources, please sign in.