Presentation
The emphasis is on clinical applications including presenting symptoms, diagnosis and treatment options for patients with EoE. [books.google.de]
Presentation in infants and children is rarely seen. Zenker diverticula typically present in people older than 50 years and especially present during the seventh and eighth decades of life. References Herbella FA, Patti MG. (2012, Jan). [review.ttu.edu.vn]
We present the case of a 77-year-old woman with a large acquired tracheal diverticulum who presented many difficulties for orotracheal intubation and hemoptysis. [archbronconeumol.org]
The clinical presentation of an H type fistula is different than the other fistulae because it does not share the common presenting signs associated with atretic esophagus. [pedclerk.uchicago.edu]
Zenker's diverticula are often found in older patients who present with dysphagia, regurgitation of undigested food, choking, hoarseness, halitosis or even a neck mass. [med-ed.virginia.edu]
Entire Body System
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Pathologist
Providing practical information useful in the treatment of patients, this book will be of great value to gastroenterologists, allergists, pathologists, medical residents, fellows, internists, and general practitioners who treat patients with eosinophilic [books.google.de]
Outstanding images – including gross pathology, a wide range of pathology stains, and detailed medical illustrations – make this an invaluable diagnostic aid for every practicing pathologist, resident, or fellow. [books.google.com]
Yantiss, MD, Professor of Pathology and Laboratory Medicine, Chief, Gastrointestinal Pathology, Weill Cornell Medical College, New York, New York Description: Diagnostic Pathology: GI Endoscopic Correlation is designed for the gastrointestinal pathologist [euro-libris.ro]
Participation of a speech pathologist or feeding therapist with pediatric expertise markedly improves the diagnostic utility of a feeding observation, and a diagnostic feeding is often carried out with concurrent radiographic assessment (see below). [nature.com]
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Swelling
Sign : Swelling, changing size, gurgling sound - Boyce's Sign (Actual it is for laryngocele) Investigation of choice : Barium swallow. [mediconotebook.com]
[…] sounds; presence of dysphagia, choking, or regurgitation Changes (improvement or lack of improvement) of symptoms Halitosis, dysphagia, regurgitation, gurgling with swallowing, coughing, persistence of a bad taste in the mouth Complications: Airway swelling [medical-dictionary.thefreedictionary.com]
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Weight Gain
Poor Weight Gain/Malnutrition/Failure to Thrive Inadequate weight gain may accompany chronic obvious feeding refusal, or it may be the first sign of subtler instances of long-term esophageal dysmotility. [nature.com]
Respiratoric
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Sputum
Abstract A 59 year-old woman admitted to our hospital due to cough and sputum was diagnosed with pneumonia by X-ray. An upper gastrointestinal series (UGI) showed an esophagobronchial fistula in mass screening 18 months before admission. [jstage.jst.go.jp]
Cardiovascular
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Cyanosis
TD was born at 39 5/7 weeks gestational age and did well at home with the exception of "choking during feeds 2-4 times per day" with mild cyanosis. [ncbi.nlm.nih.gov]
Infants born with congenital esophageal atresia/TE fistula present with coughing, gagging, cyanosis, vomiting, voluminous oral secretions, and possibly respiratory distress. [pedclerk.uchicago.edu]
Conspicuous symptoms in a newborn are frequent coughing attacks and salivate, triggered by mislead food and rattling respiration with respiratory disorders, inlcuding even cyanosis. [lecturio.com]
[…] only one of the two studies that disclosed the abnormality, highlighting the importance of considering this testing in infants with nonspecific feeding problems, that is, in infants who are well when not feeding, but develop coughing, choking, gagging, cyanosis [nature.com]
Psychiatrical
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Suggestibility
Microscopic findings of resected tissue revealed squamous epithelium covered with a muscle layer suggesting a congenital structure. The postoperative course was uneventful. [jstage.jst.go.jp]
Cross et al. [ 7 ] suggested three possible mechanisms by which diverticula could be created as a consequence of increased intra-luminal pressure. [hon.ch]
For example, case reports suggest doing a cricopharyngeal myotomy when resecting a Zenker diverticulum. Click here for Patient Education NOTE: This is the Professional Version. [merckmanuals.com]
This systematic review suggests the need for greater standardization of outcomes and instruments. [unboundmedicine.com]
Tracheotomy As suggested above, tracheotomy may independently produce dysphagia. [nature.com]
Workup
X-Ray
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Esophageal Motility Disorder
Motility Disorders 1887 Thomas W Shields 2069 Barretts Esophagus 1925 166 Radiographic Computed Tomographic 2079 Cardial Incompetence and Associated Mediastinum 2103 Katherine A Barsness and Marleta Reynolds 168 Mediastinal Tumor Markers 2131 Esophageal [books.google.com]
Traction diverticula of either the congenital or acquired variety are not usually accompanied by an esophageal motility disorder. [hon.ch]
Midesophageal (traction) diverticula are caused by traction from mediastinal inflammatory lesions or, secondarily, by esophageal motility disorders. [merckmanuals.com]
motility disorder, motor disorders of the esophagus 食道炎 esophagitis アルカリ性逆流性食道炎 alkaline reflux esophagitis 逆流性食道炎 reflux esophagitis 腐食性食道炎 corrossive esophagitis 食道癌 carcinoma of the esophagus 食道胃接合部癌 cancer of esophagogastric junction 進行食道癌 advanced [jsge.or.jp]
motility disorders diagnosed in 10% each. [nature.com]
Treatment
Significant updates on bariatric surgery, Barrett's esophagus, endoscopic ultrasound, endosonography, treatment of liver disease, and much more keep you current on the latest advances. [books.google.de]
Sonett and Alfred Jaretzki III 202 Foregut Cysts of the Mediastinum 2519 Benign Lymph Node Disease Involving 203 Gastroenteric Cysts and Neurenteric 2531 Biological Markers and Pathology of Frederick J Rescorla and Jay L Grosfeld 2539 Diagnosis and Treatment [books.google.com]
TREATMENT AND OUTCOMES Symptomatic Zenker's diverticula can be treated by surgical excision. Newer treatments are applied endoscopically. [clevelandclinicmeded.com]
Ishigami K, Matsuo Y, Yamane M, Suzuki H (1965) Surgical treatment of diverticula of the mid-thoracic esophagus with special reference to their pathogenesis. Arch Jpn Surg 34: 509-523. 3. [hon.ch]
Prognosis
[…] mid esophagus at level of tracheal bifurcation; becoming uncommon; previously mostly due to tuberculosis, mediastinal lymphadenitis and scarring; may be due to motor dysfunction, congenital or alkali ingestion ( Med Hypotheses 2004;62:931 ); better prognosis [pathologyoutlines.com]
Prognosis : guarded to poor. Pathogenesis Etiology Congenital or acquired. [vetstream.com]
Even in adenocarcinoma which is less sensitive to chemo and radiotherapy, combined treatment improves prognosis. [clevelandclinicmeded.com]
Prognosis and Patient Counseling. Both surgical and endoscopic modalities have high success rates for symptom improvement ( 90%). Surgical intervention does have an associated perioperative mortality of approximately 1.8%. [clinicaladvisor.com]
Therefore, the prognosis is largely dependent on early diagnosis and management including surgical correction. [patient.info]
Etiology
The possibility of a secondary motor disorder in the etiology of the diverticulum must be considered in these circumstances. [hon.ch]
They are categorized primarily by anatomic location and etiology into pulsion and traction diverticula. [ctsnet.org]
Pathogenesis Etiology Congenital or acquired. [vetstream.com]
The etiology is controversial and is probably due to elevated upper esophageal pressure, cricopharyngeus dysfunction and reflux. [radiologyassistant.nl]
View Article PubMed PubMed Central Google Scholar Macpherson RI: Gastrointestinal tract duplications: clinical, pathologic, etiologic, and radiologic considerations. Radiographics. 1993, 13: 1063-1680. [cardiothoracicsurgery.biomedcentral.com]
Epidemiology
The epidemiology of tracheo-oesophageal fistula and oesophageal atresia in Europe. EUROCAT Working Group. Arch Dis Child 1993; 68:743. GeneReviews [Internet]. Pagon RA, Bird TD, Dolan CR, et al., editors. [pedclerk.uchicago.edu]
An epidemiological study reviewed data from 2002 to 2006 in 30 countries and estimated a worldwide incidence of about 0.8 per 1,000, which is much lower than older studies. [ 6 ] The incidence of cleft palate alone is about 1 in 2,000. [patient.info]
Epidemiology Age Most esophageal diverticula occur in middle-aged adults and elderly people. Presentation in infants and children is rarely seen. [emedicine.medscape.com]
While there are differences between squamous cell carcinoma and adenocarcinoma in epidemiology, location and patterns of spread, both diseases tend to spread early outside the esophagus and both share a rather poor prognosis unless discovered early. [clevelandclinicmeded.com]
Finally, many disorders of these organs that occur in adulthood also occur in childhood, but may have different epidemiology, manifestations, or optimal management in these younger patients. [nature.com]
Pathophysiology
This volume provides a history of Eosinophilic Esophagitis (EoE), a basic understanding of the physiology of the eosinophil, and a current understanding of the pathophysiology and genetics of EoE. [books.google.de]
Staging of Alberto de Hoyos 2177 Less Common Malignant Tumors of the Diagnostic Investigation of Mediastinal 2195 The Use of Prosthetic Grafts to Replace 195 Poorly Differentiated Carcinoma of the Mediastinum 2411 2261 Benign and Malignant Neurogenic 2415 Pathophysiology [books.google.com]
Pathophysiology Pulsion type (most common) - true diverticulum - circumscribed sac or pouch created by herniation of esophageal mucosa through defect in surrounding muscularis, most commonly cranial to thoracic inlet or just in front of diaphragm. [vetstream.com]
Modern pathophysiology and treatment of esophageal diverticula. Langenbecks Arch Surg. 397(1):29-35. D'Journo XB, Ferraro P, Martin J, Chen LQ, Duranceau A. (2009 Aug). [review.ttu.edu.vn]
Pathophysiology Esophageal diverticula are classified by location in the esophagus. Upper (pharyngoesophageal, Killian-Jamieson, or Zenker), middle, or lower (epiphrenic). [emedicine.medscape.com]
Prevention
Teach the patient methods to reduce symptoms, prevent malnutrition and weight loss, and improve sleep and rest. [medical-dictionary.thefreedictionary.com]
The myotomy will prevent suture-line leak at the diverticulectomy site by relieving distal obstruction, in addition to decreasing diverticular recurrence and relieve symptoms of the underlying motility condition. [ctsnet.org]
These preventive measures are very important in elderly patients who tend to take multiple medications particularly at bedtime. Chronic lesions caused by mucosal injury often lead to strictures. [clevelandclinicmeded.com]
Half of those with GERD respond to pharmacotherapy, the other half require additional surgical intervention with fundoplication to prevent long term complications such as Barrett’s esophagus and adenocarcinoma. [pedclerk.uchicago.edu]
Adding a nonobstructing entireflux procedure is recommended to prevent the development of gastroesophageal reflux disease. Occasionally, a specific treatment such as a diverticulectomy or diverticulopexy needs to be directed to the diverticulum. [gastrointestinalatlas.com]