Zenker’s diverticulum: etiopathogenesis, symptoms and diagnosis. Comparison of operative methods

Nehring, Piotr; Krasnodębski, Ireneusz W.

doi:10.5114/pg.2013.38729

Cited by 18 publications

(24 citation statements)

References 28 publications

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“…Although characteristic symptoms of ZD are less frequently present in patients compared to dyspepsia, gastroesophageal reflux disease, or irritable bowel syndrome, its presence should always be taken into consideration during differential diagnosis of diseases of the digestive tract [ 5 ]. Family physicians are expected to be able to differentiate between a wide range of illnesses, with less in-depth knowledge in rare conditions, but to be highly competent in managing common diseases [ 16 ].…”

Section: Discussionmentioning

confidence: 99%

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Delayed diagnosis of a case of Zenker’s diverticulum. What may happen when a family physician does not visit his family physician

Aktürk¹,

Ulaş

Eroğlu

2018

European Journal of General Practice

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Introduction: Zenker’s diverticulum is a diverticulum of the mucosa of the pharynx, just above the cricopharyngeal muscle. It occurs commonly in elderly patients (over 70 years) and the typical symptoms include dysphagia, regurgitation, chronic cough, aspiration and weight loss.Case: We are reporting dysphagia in a 49-years old man who was treated as having Helicobacter Pylori gastritis for three years. Being a family physician himself, the patient applied to specialists in gastroenterology, bypassing primary care. During a casual interview on his symptoms, a family physician referred him to undergo a repeated endoscopy with suspected Zenker’s diverticulum. After being diagnosed with Zenker’s diverticulum, the patient underwent surgical intervention at the department of thoracic surgery and made a full recovery. He regained five kilograms at the end of five weeks after the operation.Conclusion: This case demonstrates once more the importance of history taking and follow-up in medical care. Attentive listening by a family physician could have probably prevented the delay of service in this case.

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Section: Discussionmentioning

confidence: 99%

“…Over time, the diverticulum grows, and patients complain of dysphagia due to oesophagus constriction by the filled diverticulum. Voice alteration and halitosis may also occur [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

Delayed diagnosis of a case of Zenker’s diverticulum. What may happen when a family physician does not visit his family physician

Aktürk¹,

Ulaş

Eroğlu

2018

European Journal of General Practice

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“…Literature has shown that esophageal manometry is not routinely required. However, it may help to illuminate the pathogenesis of the diverticulum [ 5 ] HRiM was performed in view of this patient’s atypical presentation of Zenker’s diverticulum at a relative young age compared to the classical presentation in the elderly population. HRiM revealed that the patient had a hypertensive esophagus of Jackhammer esophagus.…”

Section: Discussionmentioning

confidence: 99%

High Resolution Impedance Manometry: A Necessity or Luxury in Esophageal Motility Disorder?

et al. 2018

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Case seriesPatient: Female, 71 • Male, 48 • Female, 44 • Female, 62Final Diagnosis: Esophageal motility disorderSymptoms: DysphagiaMedication: —Clinical Procedure: ManometrySpecialty: Gastroenterology and HepatologyObjective:Rare diseaseBackground:The esophagus can be affected by a variety of disorders that may be primary or secondary to another pathologic process, but the resulting symptoms are usually not pathognomonic for a specific problem, making diagnosis and further management somewhat challenging. High resolution impedance manometry (HRiM) has established itself as a valuable tool in evaluating esophageal motility disorder. HRiM is superior in comparison with conventional water perfused manometric recordings in delineating and tracking the movement of functionally defined contractile elements of the esophagus and its sphincters, and in distinguishing the luminal pressurization of spastic esophageal contraction from a trapped bolus. Making these distinctions can help to identify achalasia, distal esophageal spasm, functional obstruction, and subtypes according to the latest Chicago Classification of Esophageal Motility Disorders version 3.0.Case Report:We report a case series of 4 patients that presented with dysphagia; and with the ancillary help of the HRiM, we are able to diagnose esophageal motility disorder and evaluate its pathogenetic mechanism. This approach aids in tailoring each management individually and avoiding disastrous mismanagement.Conclusions:From the series of case reports, we believe that HRiM has an important role to play in deciding appropriate management for patients presenting with esophageal motility disorders, and HRiM should be performed before deciding on management.

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“…Although Zenker's diverticulum is a rare condition, with an incidence rate of 0.01%-0.11% in the American population, it occurs more commonly in elderly patients (>70 years of age). 1 Typical symptoms include dysphagia, regurgitation, chronic cough, aspiration, and weight loss. However, it can remain asymptomatic for years.…”

Section: Answer To: Image 4 (Page 23): Zenker's Diverticulummentioning

confidence: 99%

“Errare Humanum Est, Perseverare Autem Diabolicum”

Rondonotti

Cengia²,

Bonfante

2017

Gastroenterology

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A 79-year-old man with no significant past medical history presented to the emergency department with a 2-day history of melena. He was hemodynamically stable and laboratory tests were unremarkable, except for normocytic anemia (hemoglobin, 9.1 g/dL; mean corpuscular volume, 82 fl; ferritin, 38 ng/mL). He reported a 7-day history of therapy with ibuprofen 200 mg twice a day for persistent lumbago. The patient underwent gastroscopy with a negative result. A colonoscopy performed the day after was also negative. He was therefore referred for an outpatient capsule endoscopy, which was performed a week later (Mirocam, Intromedic Inc., Seoul Korea). He swallowed the capsule smoothly without real-time monitoring. The patient brought the recorder back the following day; he referred that the recorder light stopped blinking approximately 30 minutes after ingestion. The capsule recording was a 25-minute video showing normal esophageal mucosa, with a very slow capsule progression (Figure A). The short recording time was interpreted as a possible system malfunction. The patient was asymptomatic, but he was unable to report capsule excretion; therefore, 6 days later an abdominal radiograph was performed, as per protocol in our center. No radiopaque object was identified and a new capsule endoscopy was scheduled. The second capsule ingestion was performed under Wi-Fi real time monitoring (Miroview RTV application; Mirocam, Intromedic Inc.). As with the previous examination, the capsule showed normal esophageal mucosa without any obvious lumen; moreover, a nonblinking capsule was clearly identified (Figure B) in several frames 5 minutes after ingestion. Twenty minutes later, the recording suddenly stopped. A plain neck and chest radiograph was performed. It showed 2 radiopaque foreign bodies, compatible with capsules, retained in the patient's neck (Figure C). What is the diagnosis? Look on page 24 for the answer and see the Gastroenterology website (www.gastrojournal.org) for more information on submitting your favorite image to Clinical Challenges and images in GI.

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Zenker’s diverticulum: etiopathogenesis, symptoms and diagnosis. Comparison of operative methods

Cited by 18 publications

References 28 publications

Delayed diagnosis of a case of Zenker’s diverticulum. What may happen when a family physician does not visit his family physician

Delayed diagnosis of a case of Zenker’s diverticulum. What may happen when a family physician does not visit his family physician

High Resolution Impedance Manometry: A Necessity or Luxury in Esophageal Motility Disorder?

“Errare Humanum Est, Perseverare Autem Diabolicum”

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