1/92. Intramural diverticulosis of the esophagus.A description is given of the etiology and pathology of intramural esophageal diverticulosis as so far discussed in the literature. In view of the course and the clinical findings in two young patients in whom this diagnosis was established, it is suggested that intramural diverticulosis develops as a result of a devolopmental disorder in the autonomic nervous system.- - - - - - - - - - ranking = 1keywords = esophagus (Clic here for more details about this article) |
2/92. Atypical esophageal diverticula associated with progressive systemic sclerosis.Five cases of unusual esophageal diverticula associated with progressive systemic sclerosis (scleroderma) or collagen vascular disease are presented. These wide-mouthed saccular diverticula were infrequently seen in a group of PSS patients with the typical motility disturbance of esophageal involvement and are reminiscent of the diverticula of the colon involved by PSS.- - - - - - - - - - ranking = 0.018689774181104keywords = motility (Clic here for more details about this article) |
3/92. Epiphrenic diverticulum composed of airway components attributed to a bronchopulmonary-foregut malformation: report of a case.Bronchopulmonary-foregut malformation (BPFM), defined originally as pulmonary sequestration with or without communication to the esophagus, has been acknowledged to include congenital foregut diverticula. We present herein the case of a 43-year-old woman with a 9-year history of dysphagia, in whom a barium meal examination demonstrated a 2.5-cm epiphrenic diverticulum and several fistulae. A laparotomy was performed and the lower esophagus without communication to the lung was pulled down and resected, followed by an esophagogastrostomy carried out with fundopexy. Since her operation, the patient has been free of symptoms. Histologically, the diverticulum was observed to be lined by stratified squamous cells, but its shape was formed by mural cartilage, smooth muscle cells, and three ciliated-cell cysts. The dysphagia was considered to have been derived from the kinked esophagus created by the rigid diverticulum, being the possible developmental arrest of a supernumerary lung bud. These findings indicate that this case may involve BPFM in the broad sense. Although several cases of bronchogenic cysts located beneath or across the diaphragm have been reported as a subgroup of BPFM, congenital epiphrenic diverticula has rarely been described.- - - - - - - - - - ranking = 0.75keywords = esophagus (Clic here for more details about this article) |
4/92. Dysphagia in oesophageal intramural pseudo-diverticulosis: fibrosis, dysmotility or web?We describe two cases of oesophageal intramural pseudo-diverticulosis associated with a cervical oesophageal web presenting as intermittent dysphagia. In both cases, disruption of the web endoscopically resulted in lasting relief from symptoms. This observation, together with a review of the literature written during the past 39 years, suggests that oesophageal web formation may be under-reported in this condition and may be more important than either dysmotility or submucosal fibrosis and stricturing in the aetiology of the dysphagia seen in these patients. All patients with a radiological diagnosis of oesophageal intramural pseudo-diverticulosis should have an endoscopic examination which may be both diagnostic and potentially therapeutic.- - - - - - - - - - ranking = 1.475089026651keywords = dysmotility, motility (Clic here for more details about this article) |
5/92. adenocarcinoma in a mid-esophageal diverticulum.The incidence of esophageal adenocarcinoma has been increasing compared with squamous cell carcinoma. The most common location of adenocarcinoma of the esophagus is the distal one third. Cancer developing in an esophageal diverticulum is uncommon, but tumors of squamous cell origin in esophageal diverticula have been reported previously. We describe an adenocarcinoma in a midesophageal diverticulum and review malignancies occurring in esophageal diverticula.- - - - - - - - - - ranking = 0.25keywords = esophagus (Clic here for more details about this article) |
6/92. Esophageal intramural pseudodiverticulosis associated with esophageal perforation.We report a rare case of esophageal intramural pseudodiverticulosis with lower esophageal stricture which perforated into the peritoneal cavity after the patient vomited. A 61-year-old man was admitted with severe chest and epigastric pain after dysphagia and vomiting. Under a diagnosis of upper gastrointestinal perforation, laparotomy was performed. The anterior wall of the abdominal esophagus was found to have ruptured, and proximal gastrectomy with abdominal esophagectomy was performed. Histological examination revealed esophageal intramural pseudodiverticulosis with esophageal stricture distal to the site of rupture, and postoperative endoscopy showed diffuse pseudodiverticulosis in the remaining esophagus. The patient is free of symptoms 5 years after the surgery. This case suggests that careful treatment may be indicated in patients with esophageal intramural pseudodiverticulosis with stricture and elevated intraluminal pressure, to minimize the possibility of severe complications such as esophageal perforation.- - - - - - - - - - ranking = 0.5keywords = esophagus (Clic here for more details about this article) |
7/92. Laparoscopic resection of an epiphrenic diverticulum of the esophagus.Diverticulectomy of epiphrenic diverticula of the esophagus is conventionally performed via left thoracotomy. We report the case of a 57-year-old man who presented with an epiphrenic diverticulum that was resected using a transperitoneal laparoscopic technique.- - - - - - - - - - ranking = 1.25keywords = esophagus (Clic here for more details about this article) |
8/92. Esophageal hypermotility associated with intramural pseudodiverticulosis. Primary esophageal disease or epiphenomena?Esophageal intramural pseudodiverticulosis is a very rare disease of unclear etiology. The clinical picture is characterized by progressive dysphagia. Because of its frequent association with alcohol abuse and subsequent weight loss, it must be differentiated reliably from esophageal carcinoma. The diagnosis is established by the characteristic detection of multiple intramural contrast accumulations in the barium esophagogram. Additional endoscopic and endosonographic confirmation and histological examination are required to exclude a malignant tumor. Moreover, associated diseases are almost always present and should also be diagnosed by pH-metry, cytology, and esophageal manometry. Good and long-lasting therapeutic success can be achieved by bouginage of the stenosis with concomitant treatment of the associated esophageal diseases. Based on two case reports of patients with this disease, we discuss the unusual association with esophageal hypermotility as well as the symptoms, clinical course, therapy, and pathogenesis of the disease.- - - - - - - - - - ranking = 0.093448870905518keywords = motility (Clic here for more details about this article) |
9/92. sarcoidosis and giant midesophageal diverticulum.traction diverticula of the midesophagus result from granulomatous inflammation of mediastinal lymph nodes. tuberculosis and histoplasmosis are known etiologies of this condition. To the best of our knowledge, this is the first report of a traction diverticulum caused by sarcoidosis.- - - - - - - - - - ranking = 0.25keywords = esophagus (Clic here for more details about this article) |
10/92. Laparoscopic approach for esophageal achalasia with epiphrenic diverticulum.We report the case of a 65-year-old woman with a 10-year history of dysphagia, regurgitation, cough, and 10-kg weight loss caused by an epiphrenic diverticulum associated with esophageal achalasia managed with a laparoscopic approach. A preoperative barium swallow showed a dilated sigmoid esophagus with a 6-cm epiphrenic diverticulum. Esophageal manometry confirmed the absence of peristalsis in the esophageal body. We performed a laparoscopic diverticulectomy and a 7-cm distal esophageal myotomy with a Dor fundoplication. The postoperative course was uneventful. On the third postoperative day a barium swallow showed no leak, and the patient started oral intake. She was discharged home 5 days after the operation free of symptoms and tolerating a soft diet. Sixteen months after surgery, she was asymptomatic and had gained 8 kg. A barium swallow showed a normal-size esophagus with regular emptying. We reaffirm the feasibility, safety, and efficacy of the laparoscopic diverticulectomy and distal myotomy with Dor fundoplication to manage epiphrenic diverticula resulting from esophageal achalasia.- - - - - - - - - - ranking = 0.5keywords = esophagus (Clic here for more details about this article) |
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