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      Pharyngoesophageal Obstruction on the Killian-Laimer Triangle by Zenker’s Diverticulum: Case Report and Clinical Significance

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          Abstract

          Zenker’s diverticulum is a form of esophageal and pharyngeal obstruction located at the Killian-Laimer triangle. It is relatively common in elderly man (seventh or eighth decade of life), and its pathophysiology is not completely understood, albeit theories regarding dysfunction of the upper esophageal sphincter were reported. The main symptoms are dysphagia and odynophagia, but it can complicate to aspiration and perforation of the pharyngeal pouch; also, it can be asymptomatic. Diagnosis is provided through a barium esophagogram. Treatment can be performed through endoscopic surgery, diverticulopexy and myotomy of the cricopharyngeus muscle, although there is no consensus among surgeons regarding the treatment of choice. We report a case of pharyngeal obstruction due to Zenker’s diverticulum which caused massive weight loss in a 76-year-old male.

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          Zenker's diverticula: pathophysiology, clinical presentation, and flexible endoscopic management.

          Albano Ferreira, Kristina D. Simmons, Veronique Baron (2007)
          Zenker's diverticulum (ZD) is the most common type of diverticulum in the upper gastrointestinal tract. Most patients are elderly and present with symptoms of dysphagia. Serious complications include aspiration and malnutrition. The most common treatments are open surgical diverticulectomy with or without cricopharyngeal myotomy and rigid endoscopic myotomy. Recently, cricopharyngeal myotomy using flexible endoscopes has been described as a treatment option for symptomatic ZD. In this article we describe the pathophysiology, clinical presentation and review the techniques and outcome following flexible endoscopic management of Zenker's diverticulum.
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            Disorders of the lower cranial nerves

            Josef Finsterer, Wolfgang Grisold (2015)
            Lesions of the lower cranial nerves (LCN) are due to numerous causes, which need to be differentiated to optimize management and outcome. This review aims at summarizing and discussing diseases affecting LCN. Review of publications dealing with disorders of the LCN in humans. Affection of multiple LCN is much more frequent than the affection of a single LCN. LCN may be affected solely or together with more proximal cranial nerves, with central nervous system disease, or with nonneurological disorders. LCN lesions have to be suspected if there are typical symptoms or signs attributable to a LCN. Causes of LCN lesions can be classified as genetic, vascular, traumatic, iatrogenic, infectious, immunologic, metabolic, nutritional, degenerative, or neoplastic. Treatment of LCN lesions depends on the underlying cause. An effective treatment is available in the majority of the cases, but a prerequisite for complete recovery is the prompt and correct diagnosis. LCN lesions need to be considered in case of disturbed speech, swallowing, coughing, deglutition, sensory functions, taste, or autonomic functions, neuralgic pain, dysphagia, head, pharyngeal, or neck pain, cardiac or gastrointestinal compromise, or weakness of the trapezius, sternocleidomastoid, or the tongue muscles. To correctly assess manifestations of LCN lesions, precise knowledge of the anatomy and physiology of the area is required.
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              Surgical Treatment of Killian-Jamieson Diverticulum

              Dong-Chan Kim, Jae Joon Hwang, Woo-Surng Lee … (2012)
              Killian-Jamieson diverticulum is a rare diverticular disease. This disease differs from Zenker's diverticulum in its location and mechanism. Various treatment modality have been attempted, but traditional surgical treatment has been recommended for a symptomatic Killian-Jamieson diverticulum due to the concern of possible nerve injury. We performed surgical treatment by cervical incision. We report here on a case of Killian-Jamieson diverticulum and we briefly review the relevant literature.
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                Author and article information

                Journal
                Journal ID (nlm-ta): Gastroenterology Res
                Journal ID (iso-abbrev): Gastroenterology Res
                Journal ID (publisher-id): Elmer Press
                Title: Gastroenterology Research
                Publisher: Elmer Press
                ISSN (Print): 1918-2805
                ISSN (Electronic): 1918-2813
                Publication date (Print): December 2015
                Publication date (Electronic): 31 December 2015
                Volume: 8
                Issue: 6
                Pages: 316-319
                Affiliations
                [a ]Department General Surgery, Santa Casa Hospital, Ribeirao Preto, SP, Brazil
                [b ]Department of Morphology, Biomedical Institute, Fluminense Federal University, Niteroi, RJ, Brazil
                Author notes
                [c ]Corresponding Author: Tulio Fabiano Leite, Rua Damiao Pinheiro Machado, 751/61, Botucatu, SP, Brazil. Email: tuliofabiano@ 123456hotmail.com
                Article
                DOI: 10.14740/gr696w
                PMC ID: 5051033
                SO-VID: 1feba7fb-36e8-486b-a5b8-182d5b24f7a5
                Copyright © Copyright 2015, Leite et al.
                License:

                This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                Date accepted : 15 December 2015
                Categories
                Subject: Case Report

                Keywords: zenker’s diverticulum,pharyngoesophageal diverticula,dysphagia
                Data availability:
                Keywords: zenker’s diverticulum, pharyngoesophageal diverticula, dysphagia

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