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Giant Zenker’s Diverticulum – Case Report


Authors: L. Tulinský;  J. Dostalík
Authors‘ workplace: Chirurgická klinika FN Ostrava, přednosta: doc. MUDr. Jan Dostalík, CSc.
Published in: Rozhl. Chir., 2011, roč. 90, č. 7, s. 386-388.
Category: Monothematic special - Original

Overview

Zenker’s diverticulum is one of the most common esophageal diverticuli. The reported prevalence in Czech population is approx. 0.5%, typically presents in the elderly. A small Zenker’s diverticulum can be asymptomatic. When a diverticulum increases in size, it can cause regurgitation and dysphagia and the condition is often complicated by aspiration and reccurent pneumonia. The diagnosis can be made on a barium esophagogram and CT scan. Surgical therapy is the treatment most commonly offered and the prognosis is excellent.

Here we report a 66-years-old male presenting with bleeding from large Zenkeręs diverticulum. He was immediately admitted to hospital. A computed tomography scan showed a large Zenker’s diverticulum protruding into the right superior hemithorax. Resection was chosen as a therapeutic option. Due to the size of the diverticuli his recovery post operation was complicated by fever, bleeding into mediastinum from the place of resection and temporary functional esophagi disorder. Histological examination confirmed ulceration inside the diverticulum as the source of bleeding. Three weeks after the surgery the patient was discharged home in a stable condition with recovered swallowing and phonation.

Key words:
Zenker’s diverticulum – diverticulectomy


Sources

1. Ludlow, A. A case of obstructed deglutition from a preternatural bag formed in the pharynx. Johnson W, Caldwell T, eds. In: Medical observations and inquiries by a society of physicians in London. London, Vol. 3, 2nd ed., 1769: 85–101.

2. Zenker, F. A., von Ziemssen, H. Krankheiten des Oesophagus. In: von Ziemssen H., ed. . Handbuch der speciellen Pathologie und Therapie. Leipzig: FC Vogel, 1877: 1–87.

3. Zeman, M., a kol. Speciální chirurgie. Galén, 2006, s. 199–200.

4. Dítě, P., a kol. Vnitřní lékařství II. Brno, 2005, s. 302.

5. Neoral, Č. Miniinvazivní chirurgie jícnu. 1. setkání hrudních chirurgů. Ročník 4, (2007), suplementum 3.

6. Lerut, T., Coosemans, W., Decaluwé, H., Decker, G., De Leyn, P., Nafteux, P., van Raemdonck, D. Zenker’s diverticulum. University Hospitals Leuven, Belgium, MMCTS (February 24, 2009), http://mmcts.ctsnetjournals.org/cgi/content/full/2009/0224/mmcts.2007.002881

7. Gutschow, C. A, Hamoir, M., Rombaux, P., Otte, J. B., Goncette, L., Collard, J. M. Management of pharyngoesophageal (Zenker‘s diverticulum: which technique?). Ann. Thorac. Surg., 2002;7 4: 1677–1683.

http://ats.ctsnetjournals.org/cgi/content/full/74/5/1677?ijkey =c73ec26fb051b7d3595633de26f48ab74730b28d

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