Zenker diverticulum: a case report

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

Sinan Kocatürk Güçlü Kaan Beriat Cem Doğan

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.

Anahtar Kelimeler

Open diverticulectomy, posterior cricopharyngeal myotomy, Zenker’s diverticulum

Zenker divertikülü: Olgu sunumu

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

Anahtar Kelimeler

Açık divertikülektomi, posteriyor krikofarengeal miyotomi, Zenker divertikülü

Kaynakça

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