TEDs usually present with dysphagia or recurrent aspiration. We describe here a rare presentation of upper gastro-intestinal bleeding resulting from ulceration and fistulization of the TED. [springerplus.springeropen.com]

Giant cell formation is rare, but fused histiocytes are present. [acgcasereports.gi.org]

Abstract Patients with esophageal diverticula may present with a variety of symptoms. Many of these symptoms mimic less serious disease, making diagnosis of esophageal diverticulum difficult for many primary care physicians. [ncbi.nlm.nih.gov]

If symptoms are not present at diagnosis, they rarely occur during follow-up. [clinicalgate.com]

Presenting symptoms of Epiphrenic esophageal diverticula depends on the underlying disease process and they mostly present with alarming symptoms. [omicsonline.org]

• Weight Loss

  Physical examination The most common symptoms are dysphagia, achalasia, weight loss, and regurgitation. Assess the patient’s appearance, noting apparent weight loss or the malnourished look that is associated with anorexia. [medical-dictionary.thefreedictionary.com]

  We present an unusual case of a 43-year-old patient with a history of leiomyoma resection of the esophagus and an ensuing placement of a laparoscopic band for weight loss. [ncbi.nlm.nih.gov]

  Dysphagia, food regurgitation, chest pain, weight loss, and reflux symptoms are the most commonly encountered gastrointestinal symptoms. [gastrointestinalatlas.com]

  He denied any fevers, unintentional weight loss, hemoptysis, sore throat, odynophagia, shortness of breath, or wheezing. On examination he was hemodynamically stable. Chest exam revealed lower left lung crackles. [acgcasereports.gi.org]

  loss Neck mass References: [1] [2] [6] [3] Diagnostics Barium swallow (best confirmatory test ) with dynamic continuous fluoroscopy Visualization of diverticula via barium swallow or gastrografin (soluble in water) Allows detection of underlying motor [amboss.com]

• Fever

  Fever, cough, pleuritic chest pain are common complains of aspiration pneumonia. [2] Presence of risk factors Patients with a history of tuberculosis can have traction diverticula, secondary to inflammation and scarring of the mediastinal lymph nodes. [explainmedicine.com]

  He denied any fevers, unintentional weight loss, hemoptysis, sore throat, odynophagia, shortness of breath, or wheezing. On examination he was hemodynamically stable. Chest exam revealed lower left lung crackles. [acgcasereports.gi.org]

  People with peritonitis always have a fever, and the belly often feels hard and bloated. Untreated, peritonitis causes death in a few hours or days. [medbroadcast.com]

  Diverticulitis comes with a number of other symptoms, including fever, abdominal tenderness constipation, diarrhea, nausea, vomiting and a change in bowel movement frequency. [livescience.com]

  […] 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, fever [medical-dictionary.thefreedictionary.com]

• Surgical Procedure

  The technical key steps of the surgical procedure are presented in a step by step way: exposure of diverticulum, dissection of diverticulum, dividing the neck of the diverticulum. [websurg.com]

  Figure 2 A photograph shows the positioning of surgical wound and instruments. Figure 3 Photographs show the surgical procedures. [jtd.amegroups.com]

  If the bleeding does not stop, you may need a segmental resection, which is a surgical procedure to remove part of an organ (in this case, part of the intestines). [medbroadcast.com]

  Zenker’s diverticula may be treated by open surgical procedures or by transoral endoscopic techniques with rigid or flexible fiberoptic instruments. [clinicalgate.com]

  Surgical Treatment Zenkers- There are several different surgical procedures employed for treatment of Zenkers diverticula with the preferred option being concomitant diverticulectomy and cricopharyngeal myotomy. [clinicaladvisor.com]

• Anemia

  When these occur in the upper esophagus, they may be associated with other diseases such as iron deficiency anemia or graft versus host disease. Some authors believe that webs that arise in the mid to distal esophagus may be related to reflux. [ddc.musc.edu]

  Allergic Purpura 60 Alzheimers Disease 63 Amputation 68 Amyloidosis 73 Amyotrophic Lateral Sclerosis 77 Anaphylaxis 82 Angina Pectoris 86 Anorectal Abscess and Fistula 92 Anorexia Nervosa 96 Aortic Valve Insufficiency 100 Aortic Valve Stenosis 104 Aplastic Anemia [books.google.com]

  Hypochromic anemia frequently associated due to repeated or permanent small bleedings. They are caused by a regional destruction a gastric mucosa. [intranet.tdmu.edu.ua]

  If a very small amount leaks out continually, it can still add up over time and cause mild anemia. Bleeding that doesn't stop always requires treatment. [medbroadcast.com]

  […] web 10% incidence at autopsy Can be congenital or acquired Most in hypopharynx and proximal esophagus Majority protrude from anterior esophageal wall Symptoms if lumen > 50% compromised Sideropenic dysphagia (Plummer-Vinson syndrome) Iron deficiency anemia [radiologyassistant.nl]

• Fishing

  […] reduce spicy, fatty, and acidic foods in your diet. [9] Some things you may eat include: Vegetables, such as broccoli, cabbage, and peas Legumes, including kidney beans, black beans, and tofu products Lean meats such as chicken, lean ground beef, and fish [wikihow.com]

• Dysphagia

  Esophagram for Patient 2, 75-year-old woman with regurgitation, dysphagia, pain, and odynophagia. Figure 2. Esophagram for Patient 2, 75-year-old woman with regurgitation, dysphagia, pain, and odynophagia. Figure 3. [jaoa.org]

  […] esophagus Cause of Zenker's diverticulum and pulsion diverticula ↑ pressure during swallowing Location of Zenker's diverticulum Between cricopharyngeus (UES) and thyropharyngeus portion of inferior pharyngeal constrictors SSx of Zenker's diverticulum Dysphagia [quizlet.com]

  Rarely, the pouch becomes large, causing dysphagia and sometimes a palpable neck mass. Traction and epiphrenic diverticula are rarely symptomatic, although their underlying cause may be. [merckmanuals.com]

  Clinicians should be aware of the possibility of traction mid-esophageal diverticulum in sarcoidosis patients with progressive dysphagia. [acgcasereports.gi.org]

  Epidemiology Rare diverticula compared to other gastrointestinal sites (prompting < 1% of all barium swallows and accounting for < 5% of all cases of dysphagia ). [amboss.com]

• Regurgitation of Undigested Food

  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]

  […] of undigested food, dysphagia Tx for Traction diverticulum Excision w 1° closure, palliative XRT if 2/2 invasive CA Location of epiphrenic diverticulum Cause of epiphrenic diverticulum SSx of epiphrenic diverticulum ASx, dysphagia, regurgitation Dx of [quizlet.com]

  Regurgitation of undigested foods is primary seen when the lipoma is located in the cervical part of the esophagus, with intraluminal growing and obstruction. [karger.com]

  Surgical treatments are indicated in the patients with symptoms such as dysphagia or regurgitation of undigested food ( 3, 5 ). Traditionally, thoracotomy has been the preferred surgical approach ( 3 ). [jtd.amegroups.com]

  Patients complain of regurgitation of undigested food in to the mouth. [explainmedicine.com]

• Choking

  Development of fistula between the diverticulum and the airway can also cause choking and aspiration. [1,2,3] Recurrent respiratory tract infections Patients with fistula between the diverticulum and the respiratory airways can present with recurrent [explainmedicine.com]

  Cause of Zenker's diverticulum and pulsion diverticula ↑ pressure during swallowing Location of Zenker's diverticulum Between cricopharyngeus (UES) and thyropharyngeus portion of inferior pharyngeal constrictors SSx of Zenker's diverticulum Dysphagia, choking [quizlet.com]

  People also experience: Choking feelings A feeling of mucous collecting in the throat Hoarse speech Bad breath Tests for Diagnosing Zenker’s Diverticulum Experts don’t know exactly what causes Zenker’s diverticulum, but do know it’s associated with increased [upmc.com]

  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]

  Recommend that the patient sleep with the head elevated (using pillows or bed blocks) to reduce esophageal reflux and nocturnal choking. [medical-dictionary.thefreedictionary.com]

• Melena

  […] a closed glottis increased intra-abdominal pressure can cause a tear in the mucosa (Mallory-Weiss tear) of the esophagus at the esophagogastric junction – A transmural esophageal tear is called Boerhaave’s syndrome – A history of emesis followed by melena [docsity.com]

  Diverticulum Traction esophageal diverticulum: a rare cause of gastro-intestinal bleeding A 61-year-old male with multiple co-morbidities including atrial fibrillation managed with beta blockers and anticoagulation presented with recurrent hemetemesis and melena [springerplus.springeropen.com]

  Thus, melena can be seen. The diagnostic imaging tools for determining esophageal masses are endoscopic examination of the upper gastrointestinal tract, CT of the chest and barium swallow tests [ 1 - 3 ]. [karger.com]

• Constipation

  Diverticulitis comes with a number of other symptoms, including fever, abdominal tenderness constipation, diarrhea, nausea, vomiting and a change in bowel movement frequency. [livescience.com]

  The acquired diaphragmatic hernia more often arise owing to age-dependent involution of diaphragm, its ptosis in the people with a mainly sedentary mode of life, increase of intraperitoneal pressure, obesity, cough, overfeeding, constipation, meteorism [intranet.tdmu.edu.ua]

• Halitosis

  Zenker's diverticulum and pulsion diverticula ↑ pressure during swallowing Location of Zenker's diverticulum Between cricopharyngeus (UES) and thyropharyngeus portion of inferior pharyngeal constrictors SSx of Zenker's diverticulum Dysphagia, choking, halitosis [quizlet.com]

  Note halitosis, a common sign of esophageal diverticula. Inspect the patient’s neck for visible signs of esophageal distention that has been caused by food trapped in the diverticula. [medical-dictionary.thefreedictionary.com]

  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]

  Symptoms may include difficulty swallowing ( dysphagia ), chronic coughing, regurgitation, or bad breath (halitosis). [everydayhealth.com]

  References: [1] [2] [5] [3] Clinical features Clinical presentation depends on diverticulum size and localization Dysphagia (most common) Regurgitation of undigested food Aspiration Coughing after food intake Retrosternal pressure sensation and pain Halitosis [amboss.com]

• Polyps

  Polyps are treated by local resection. MALIGNANT TUMORS DEFINITION AND CLASSIFICATION Malignant tumors of the esophagus constitute the majority of esophageal tumors. [clevelandclinicmeded.com]

  Approximately 60% of the benign esophageal neoplasms are leiomyomas, 20% are cysts, 5% are polyps and less than 1% are lipomas. Indeed, Mayo et al. [ 1 ] reported comprehensive clinical cases of benign neoplasms of the digestive tract. [karger.com]

The patient underwent a surgical treatment and recovered completely. [ncbi.nlm.nih.gov]

Transoral, endoscopic stapler Opens diverticulum and divides cricopharyngeaus Treatment of mid-esophageal, traction diverticula Right thoracotomy Diverticulectomy Contralateral esophagomytomy if motility disorder suspected Treatment of epiphrenic diverticula [brainscape.com]

Conservative treatment still holds a place of promise for treatment of epiphrenic esophageal diverticulum [ 6 ]. [npplweb.com]

[…] typically associated with mediastinal granulomatous disease (TB, histoplasmosis) • They are usually small with a blunt tapered tip that points upward • These are usually an incidental finding on barium swallow • They rarely cause symptoms or require treatment [docsity.com]

[…] 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]

Treatment and Prognosis Patients with small asymptomatic or minimally symptomatic diverticula can be followed, because progressive enlargement is uncommon. 2 Patients with large and symptomatic Zenker’s diverticula should be offered treatment. [clinicalgate.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]

Even in adenocarcinoma which is less sensitive to chemo and radiotherapy, combined treatment improves prognosis. [clevelandclinicmeded.com]

A number of distinct types of esophageal diverticula are found clinically with distinct locations, etiologies, and clinical consequences. All are true diverticula and thus are surrounded by all histological layers of the esophageal wall. [pathwaymedicine.org]

Pathogenesis Etiology Congenital or acquired. [vetstream.com]

Although its etiology has not been definitively established, ZD appears to be caused by the discoordination between the two muscle groups. [enttoday.org]

Tuberculosis and histoplasmosis are known etiologies of this condition. 2 Figure 2. Lung biopsy showing dense fibrosis encasing hard granulomata composed of epithelioid histiocytes. [acgcasereports.gi.org]

This reason for the development of a diverticulum is not a familiar etiology for esophageal diverticula. The most common etiological factor for esophageal diverticula is pulsion diverticulum due to increased intraluminal pressure. [karger.com]

Epidemiology Rare diverticula compared to other gastrointestinal sites (prompting < 1% of all barium swallows and accounting for < 5% of all cases of dysphagia ). [amboss.com]

Other methods include fibreoptic diverticular repair. [7] Other non-surgical treatment modalities also exist, such as endoscopic laser, which recent evidence suggests is less effective than stapling. [8] Epidemiology [ edit ] Zenker's diverticulum mainly [en.wikipedia.org]

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]

[…] of Zenker's diverticulum Hypertonicity of criciopharyngeaus muscle (Lower esophageal motility and LES normal) Pathophysiology of epiphrenic diverticulum False diverticulum Esophageal dysmotility disorder Within 4 cm of GEJ Pathophysiology of mid-thoracic [brainscape.com]

Pathophysiology (see “Pathophysiology” below) Pulsion Diverticula Traction Diverticula References: [1] [2] [4] [3] Pathophysiology Anatomy 3 constrictions of the esophagus The cervical constriction: beginning of the esophagus (upper esophageal opening [amboss.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]

Pathophysiology Esophageal diverticula are classified by location in the esophagus. Upper (pharyngoesophageal, Killian-Jamieson, or Zenker), middle, or lower (epiphrenic). [emedicine.medscape.com]

PATHOPHYSIOLOGY Virtually all mucosal injuries are accompanied by inflammation with various degrees of severity including from erythema, frank ulcers with potential scarring and bleeding and strictures. [clevelandclinicmeded.com]

Teach the patient methods to reduce symptoms, prevent malnutrition and weight loss, and improve sleep and rest. [medical-dictionary.thefreedictionary.com]

Emphasize the need to chew food thoroughly to prevent food particles from becoming trapped in the diverticulum. Teach the patient how to perform massage or postural drainage to prevent aspiration. [nursingfile.com]

It may also help prevent food from becoming stuck in the diverticula pockets. [wikihow.com]

Afterwards, patients may be placed on anti-reflux medications to try to prevent recurrence. Esophageal diverticula are outpocketings of one or more layers of the esophageal wall. [ddc.musc.edu]

This procedure has been excogitated to control of symptoms due to esophageal motility disorders and to prevent postoperative symptoms due to reflux, stenosis, and leak. [symbiosisonlinepublishing.com]