BibTex RIS Kaynak Göster

Zenker diverticulum: a case report

Yıl 2009, Cilt: 19 Sayı: 6, 311 - 315, 12.12.2009

Öz

Zenker’s diverticulum is a pulsion typed pharyngoeosophageal diverticle caused by the herniation of the pharyngeal mucosa, standing beside the posterior pharyngeal wall, through the Killian opening which is known as the weak area between the inferior constructor muscle’s oblique fibres and transverse fibres of cricopharyngeal muscle. In patients with Zenker’s Diverticulum, symptoms such as disfagia, globus in the cervical area, weigth loss, regurgitation, cough, and aspiration. These patients are primarily admitted to the Gastroenterology and Othorhinolaryngology clinics with the complaint of disfagia and the diagnosis of this disease is mostly established late and the treatment is started late because the results of their physical examinations seem normal. Therefore, especially in the patients who have disfagia complaint, pharyngoeosophageal diverticle prediagnosis should be thought and that should be examined by passage graphies with barium and endoscopic methods, if needed. In this article, we presented the 67-year-old Zenker’s Diverticulum patient in whom we performed open diverticulectomy and posterior cricopharyngeal myotomy, and we specified the important points in choosing the patient and the type of surgery.

Kaynakça

  • Rubesin SE, Levine MS. Killian-Jamieson divertic- ula: radiographic findings in 16 patients. AJR Am J Roentgenol 2001;177:85-9.
  • van Overbeek JJ. Meditation on the pathogenesis of hypopharyngeal (Zenker’s) diverticulum and a report of endoscopic treatment in 545 patients. Ann Otol Rhinol Laryngol 1994;103:178-85.
  • van Overbeek JJ. Pathogenesis and methods of treat- ment of Zenker’s diverticulum. Ann Otol Rhinol Laryngol 2003;112:583-93.
  • Yılmaz M, Ersin S, Kapkaç M, Akgün E, Kara E, Yararbaş Ö. Zenker’s diverticulum and surgical treat- ment. Turkiye Klinikleri J Gastroenterohepatol 1996; 7:160-2.
  • Tanna N, Patel AA, Eisler LS, Goding G, Maisel R. Bilobed Zenker’s diverticula. Ann Otol Rhinol Laryngol 2007;116:278-80.
  • Ferreira LE, Simmons DT, Baron TH. Zenker’s diver- ticula: pathophysiology, clinical presentation, and flexible endoscopic management. Dis Esophagus 2008; 21:1-8.
  • Akın M, Anadol AZ, Kurukahvecioğlu O, Bostancı H, Tezel E, Çifter Ç. Zenker’s Diverticulum: A case series. The New Journal of Medicine 2008; 25:86-88.
  • Chang CW, Burkey BB, Netterville JL, Courey MS, Garrett CG, Bayles SW. Carbon dioxide laser endoscop- ic diverticulotomy versus open diverticulectomy for Zenker’s diverticulum. Laryngoscope 2004;114:519-27.
  • Bonavina L, Bona D, Abraham M, Saino G, Abate E. Long-term results of endosurgical and open sur- gical approach for Zenker diverticulum. World J Gastroenterol 2007;13:2586-9.
  • Feeley MA, Righi PD, Weisberger EC, Hamaker RC, Spahn TJ, Radpour S, et al. Zenker’s diverticulum: analysis of surgical complications from diverticulec- tomy and cricopharyngeal myotomy. Laryngoscope 1999;109:858-61.
  • Chang CY, Payyapilli RJ, Scher RL. Endoscopic staple diverticulostomy for Zenker’s diverticulum: review of literature and experience in 159 consecutive cases. Laryngoscope 2003;113:957-65.
  • Sen P, Bhattacharyya AK. Endoscopic stapling of pha- ryngeal pouch. J Laryngol Otol 2004;118:601-6.
  • Philippsen LP, Weisberger EC, Whiteman TS, Schmidt JL. Endoscopic stapled diverticulotomy: treatment of choice for Zenker’s diverticulum. Laryngoscope 2000; 110:1283-6.
  • Visosky AM, Parke RB, Donovan DT. Endoscopic man- agement of Zenker’s diverticulum: factors predictive of success or failure. Ann Otol Rhinol Laryngol 2008; 117:531-7.
  • Palmer AD, Herrington HC, Rad IC, Cohen JI. Dysphagia after endoscopic repair of Zenker’s diver- ticulum. Laryngoscope 2007;117:617-22.
  • Brücher BL, Sarbia M, Oestreicher E, Molls M, Burian M, Biemer E, et al. Squamous cell carcinoma and Zenker diverticulum. Dis Esophagus 2007;20:75-8.

Zenker divertikülü: Olgu sunumu

Yıl 2009, Cilt: 19 Sayı: 6, 311 - 315, 12.12.2009

Öz

Zenker divertikülleri; farengeal mukozanın posteri- yor farengeal duvarda bulunan, inferior konstrüktör farengeal kasın oblik lifleri ile krikofarengeal kasın transfers lifleri arasındaki Killian açıklığı olarak bilinen zayıf alandan fıtıklaşması sonucu oluşan pulsiyon tipinde farengoözofageal divertiküllerdir. Zenker divertikülü hastalarında başta disfaji olmak üzere servikal bölgede takılma hissi, kilo kaybı, regürjitasyon, öksürük, aspirasyon gibi semptomlar görülebilmektedir. Bu hastalar başta disfaji yakın- masıyla Gastroenteroloji ve Kulak Burun Boğaz kliniklerine başvurmakta ve çoğu zaman rutin fizik muayenelerinin normal olması nedeni ile hastalık- larının tanı ve tedavisinde geç kalınmaktadır. Bu nedenle disfaji yakınmasıyla başvuran özellikle yaşlı hastalarda farengoözofageal divertikül ön tanısı mutlaka düşünülmeli, baryumlu pasaj grafi- leri ve gerekiyorsa endoskopik yöntemler ile mut- laka değerlendirilmelidir. Biz makalemizde, Zenker divertikülü nedeni ile açık divertikülektomi ve pos- teriyor krikofarengeal miyotomi uyguladığımız 67 yaşındaki olguyu sunarak, hasta seçimi ve hasta- lığın cerrahisi sırasında dikkat edilmesi gereken noktaları belirttik

Kaynakça

  • Rubesin SE, Levine MS. Killian-Jamieson divertic- ula: radiographic findings in 16 patients. AJR Am J Roentgenol 2001;177:85-9.
  • van Overbeek JJ. Meditation on the pathogenesis of hypopharyngeal (Zenker’s) diverticulum and a report of endoscopic treatment in 545 patients. Ann Otol Rhinol Laryngol 1994;103:178-85.
  • van Overbeek JJ. Pathogenesis and methods of treat- ment of Zenker’s diverticulum. Ann Otol Rhinol Laryngol 2003;112:583-93.
  • Yılmaz M, Ersin S, Kapkaç M, Akgün E, Kara E, Yararbaş Ö. Zenker’s diverticulum and surgical treat- ment. Turkiye Klinikleri J Gastroenterohepatol 1996; 7:160-2.
  • Tanna N, Patel AA, Eisler LS, Goding G, Maisel R. Bilobed Zenker’s diverticula. Ann Otol Rhinol Laryngol 2007;116:278-80.
  • Ferreira LE, Simmons DT, Baron TH. Zenker’s diver- ticula: pathophysiology, clinical presentation, and flexible endoscopic management. Dis Esophagus 2008; 21:1-8.
  • Akın M, Anadol AZ, Kurukahvecioğlu O, Bostancı H, Tezel E, Çifter Ç. Zenker’s Diverticulum: A case series. The New Journal of Medicine 2008; 25:86-88.
  • Chang CW, Burkey BB, Netterville JL, Courey MS, Garrett CG, Bayles SW. Carbon dioxide laser endoscop- ic diverticulotomy versus open diverticulectomy for Zenker’s diverticulum. Laryngoscope 2004;114:519-27.
  • Bonavina L, Bona D, Abraham M, Saino G, Abate E. Long-term results of endosurgical and open sur- gical approach for Zenker diverticulum. World J Gastroenterol 2007;13:2586-9.
  • Feeley MA, Righi PD, Weisberger EC, Hamaker RC, Spahn TJ, Radpour S, et al. Zenker’s diverticulum: analysis of surgical complications from diverticulec- tomy and cricopharyngeal myotomy. Laryngoscope 1999;109:858-61.
  • Chang CY, Payyapilli RJ, Scher RL. Endoscopic staple diverticulostomy for Zenker’s diverticulum: review of literature and experience in 159 consecutive cases. Laryngoscope 2003;113:957-65.
  • Sen P, Bhattacharyya AK. Endoscopic stapling of pha- ryngeal pouch. J Laryngol Otol 2004;118:601-6.
  • Philippsen LP, Weisberger EC, Whiteman TS, Schmidt JL. Endoscopic stapled diverticulotomy: treatment of choice for Zenker’s diverticulum. Laryngoscope 2000; 110:1283-6.
  • Visosky AM, Parke RB, Donovan DT. Endoscopic man- agement of Zenker’s diverticulum: factors predictive of success or failure. Ann Otol Rhinol Laryngol 2008; 117:531-7.
  • Palmer AD, Herrington HC, Rad IC, Cohen JI. Dysphagia after endoscopic repair of Zenker’s diver- ticulum. Laryngoscope 2007;117:617-22.
  • Brücher BL, Sarbia M, Oestreicher E, Molls M, Burian M, Biemer E, et al. Squamous cell carcinoma and Zenker diverticulum. Dis Esophagus 2007;20:75-8.
Toplam 16 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Bölüm Olgu Sunumu
Yazarlar

Sinan Kocatürk Bu kişi benim

Güçlü Kaan Beriat Bu kişi benim

Cem Doğan Bu kişi benim

Yayımlanma Tarihi 12 Aralık 2009
Yayımlandığı Sayı Yıl 2009 Cilt: 19 Sayı: 6

Kaynak Göster

APA Kocatürk, S., Beriat, G. K., & Doğan, C. (2009). Zenker divertikülü: Olgu sunumu. The Turkish Journal of Ear Nose and Throat, 19(6), 311-315.
AMA Kocatürk S, Beriat GK, Doğan C. Zenker divertikülü: Olgu sunumu. Tr-ENT. Aralık 2009;19(6):311-315.
Chicago Kocatürk, Sinan, Güçlü Kaan Beriat, ve Cem Doğan. “Zenker divertikülü: Olgu Sunumu”. The Turkish Journal of Ear Nose and Throat 19, sy. 6 (Aralık 2009): 311-15.
EndNote Kocatürk S, Beriat GK, Doğan C (01 Aralık 2009) Zenker divertikülü: Olgu sunumu. The Turkish Journal of Ear Nose and Throat 19 6 311–315.
IEEE S. Kocatürk, G. K. Beriat, ve C. Doğan, “Zenker divertikülü: Olgu sunumu”, Tr-ENT, c. 19, sy. 6, ss. 311–315, 2009.
ISNAD Kocatürk, Sinan vd. “Zenker divertikülü: Olgu Sunumu”. The Turkish Journal of Ear Nose and Throat 19/6 (Aralık 2009), 311-315.
JAMA Kocatürk S, Beriat GK, Doğan C. Zenker divertikülü: Olgu sunumu. Tr-ENT. 2009;19:311–315.
MLA Kocatürk, Sinan vd. “Zenker divertikülü: Olgu Sunumu”. The Turkish Journal of Ear Nose and Throat, c. 19, sy. 6, 2009, ss. 311-5.
Vancouver Kocatürk S, Beriat GK, Doğan C. Zenker divertikülü: Olgu sunumu. Tr-ENT. 2009;19(6):311-5.