Epiphrenic Diverticulum and Zenker's Diverticulum: Simultaneous Double Surgical Approach: Case Report
Main Article Content
Abstract
Esophageal diverticula are a rare condition, with an incidence of 0.06 to 4% and can present as pharyngoesophageal (Zenker), mid-esophageal (epibronchial), and/or distal diverticula, the latter also called epiphrenic, representing 15% of all diverticula. The importance of timely diagnosis and treatment lies in reducing complications and, therefore, morbidity.
We present the case of a 74-year-old female patient who, in her diagnostic approach due to a clinical picture of dysphagia, was identified as having the presence of a Zenker's diverticulum and an epiphrenic diverticulum, so she was scheduled for double diverticulectomy, with a conventional cervical approach (open) and a laparoscopic abdominal approach, at UMAE 25 in Monterrey, Nuevo León, México.
Article Details
This work is licensed under a Creative Commons Attribution 4.0 International License.
References
I. Ballesteros-Barrera I, Barrera-Zavala A, Durán-Briones G, Carmona-Rodríguez A. Divertículo Esofágico Epifrénico. Cir Gen. 2021;43(2):132-136. https://doi.org/10.35366/106725
II. Zaninotto G. Tratamiento actual del divertículo de Zenker. Cir Española. 2012, 90(4):213-214. https://www.elsevier.es/es-revista-cirugia-espanola-36-articulo-tratamiento-actual-del-diverticulo-zenker-S0009739X1200084X
III. Martínez J. La asociación de divertículo de Zenker y acalasia. Rev Facultad Med Univ Nac Colombia Bogotá. 2008, 56(1):65-70.
https://revistas.unal.edu.co/index.php/revfacmed/article/view/18596/19494
IV. Sivarao Dv, Goyal Rk. Funtional anatomy and physiology of the upper esophageal sphincter. Am J Med. 2000;108: Suppl 4a:27s-37s.
https://doi.org/10.1016/s0002-9343(99)00337-x
V. Soares R, Herbella FA, Prachand VN, Ferguson MK, Patti MG. Epiphrenic diverticulum of the esophagus. From pathophysiology to treatment. J Gastrointest Surg. 2010; 14: 2009-2015.
https://doi.org/10.1007/s11605-010-1216-9
VI. Santos MPD, Akerman D, Santos CPDD, Santos Filho PVD, Radtke MC, Beraldo FB, et al. Giant esophageal epiphrenic diverticulum: presentation and treatment. Einstein (Sao Paulo). 2017; 15: 486-488.https://doi.org/10.1590/s1679-45082017rc3954
VII. Cadena DP, de Moura DTH, Hirsch B, Peixoto GH, Kum AST, Mahmood S, et al. Flexible endoscopy versus rigid endoscopy or surgery for the management of Zenker’s diverticulum: A systematic review and meta-analysis. Cureus.
;15(8):e43021. http://dx.doi.org/10.7759/cureus.43021
VIII. Bizzotto A, Iacopini F, Landi R, Costamagna G. Zenker’s diverticulum: exploring treatment options. Acta Otorhinolaryngol Ital. 2013;33(4):219–29. https://pmc.ncbi.nlm.nih.gov/articles/PMC3773964/
IX. Dzeletovic I, Ekbom DC, Baron TH. Flexible endoscopic and surgical management of Zenker's diverticulum. Expert Rev Gastroenterol Hepatol. 2012;6(4):449-65; quiz 466.
https://doi.org/10.1586/egh.12.25
X. Brandeis AE, Singhal S, Lee TH, Mittal SK. Surgical management of epiphrenic diverticulum: A single-center experience and brief review of literature. Am J Surg [Internet]. 2018;216(2):280–5. http://dx.doi.org/10.1016/j.amjsurg.2017.06.039
XI. de Angulo Martín DR, Ángeles Ortiz Escandell M, Martínez de Haro LF, Ruiz VM, Paricio PP. Epiphrenic diverticula: when and how to operate? Cir Esp (Engl Ed). 2009;85(4):196–204. http://dx.doi.org/10.1016/s2173-5077(09)70134-6
XII. Magee MJ, Sonett JR. Management of epiphrenic esophageal diverticula. Oper Tech Thorac Cardiovasc Surg. 2011;16(1):18–29.
http://dx.doi.org/10.1053/j.optechstcvs.2011.04.001
XIII. Minneman JA, Wright AS. Epiphrenic Diverticula: Diagnosis and Management. En: Foregut Surgery. Cham: Springer International Publishing. 2020:61–8. https://ouci.dntb.gov.ua/en/works/l1E8deyl/
XIV. Lakhani DA, Hadi YB, Smith M. Epiphrenic Diverticulum. Clin Gastroenterol Hepatol. 2021 Aug;19(8):e75-e76. https://doi.org/10.1016/j.cgh.2020.04.011
XV. Sato Y, Tanaka Y, Ohno S, Endo M, Okumura N, Takahashi T, et al. Optimal surgical approaches for esophageal epiphrenic diverticulum: literature review and our experience. Clin J Gastroenterol. 2023;16(3):317-324. https://doi.org/10.1007/s12328-023-01765-2