一名患有瓦伦贝里综合征和基里安-贾米森憩室的患者出现严重吞咽困难:病例报告

Carmel Cotaoco, Takao Goto, Misaki Koyama, Taku Sato, Kenji Kondo, Rumi Ueha
{"title":"一名患有瓦伦贝里综合征和基里安-贾米森憩室的患者出现严重吞咽困难:病例报告","authors":"Carmel Cotaoco, Takao Goto, Misaki Koyama, Taku Sato, Kenji Kondo, Rumi Ueha","doi":"10.1007/s42399-024-01713-2","DOIUrl":null,"url":null,"abstract":"<p>Lateral medullary syndrome (Wallenberg syndrome) and Killian Jamieson diverticulum are both conditions known to cause dysphagia. Here, we present the first reported case of severe dysphagia due to Wallenberg syndrome and a Killian Jamieson diverticulum discovered incidentally during videofluoroscopic swallowing study. A 66-year-old male previously diagnosed with Wallenberg syndrome was referred to our hospital due to severe dysphagia. Pre-operative work-up revealed decreased left-sided pharyngeal contraction, left vocal fold paralysis, impaired laryngeal elevation, and poor upper esophageal sphincter relaxation during swallowing. Furthermore, on videofluoroscopic swallowing study, an incidental finding of a contrast-filled outpouching of the esophagus on the left, below the level of the cricopharyngeus, indicated the presence of a pharyngoesophageal diverticulum. The patient underwent bilateral cricopharyngeal myotomy with diverticulectomy, laryngeal suspension surgery, and tracheostoma revision. The diagnosis of a Killian Jamieson diverticulum was confirmed based on intra-operative findings, as the diverticular pouch was indeed seen to be located below the cricopharyngeal muscle. For patients with severe dysphagia that does not improve with swallowing rehabilitation, swallowing improvement surgery is an option. It aims to improve pre-operatively identified dysfunctional sites in the swallowing mechanism. It is important to always consider pharyngoesophageal diverticula as a possible cause of dysphagia so as not to miss the diagnosis. In this patient’s case, diverticulectomy was necessary to ensure the best possible outcomes in terms of improving his dysphagia.</p>","PeriodicalId":21944,"journal":{"name":"SN Comprehensive Clinical Medicine","volume":"6 1","pages":""},"PeriodicalIF":0.0000,"publicationDate":"2024-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Severe Dysphagia in a Patient with Wallenberg Syndrome and Killian Jamieson Diverticulum: A Case Report\",\"authors\":\"Carmel Cotaoco, Takao Goto, Misaki Koyama, Taku Sato, Kenji Kondo, Rumi Ueha\",\"doi\":\"10.1007/s42399-024-01713-2\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p>Lateral medullary syndrome (Wallenberg syndrome) and Killian Jamieson diverticulum are both conditions known to cause dysphagia. Here, we present the first reported case of severe dysphagia due to Wallenberg syndrome and a Killian Jamieson diverticulum discovered incidentally during videofluoroscopic swallowing study. A 66-year-old male previously diagnosed with Wallenberg syndrome was referred to our hospital due to severe dysphagia. Pre-operative work-up revealed decreased left-sided pharyngeal contraction, left vocal fold paralysis, impaired laryngeal elevation, and poor upper esophageal sphincter relaxation during swallowing. Furthermore, on videofluoroscopic swallowing study, an incidental finding of a contrast-filled outpouching of the esophagus on the left, below the level of the cricopharyngeus, indicated the presence of a pharyngoesophageal diverticulum. The patient underwent bilateral cricopharyngeal myotomy with diverticulectomy, laryngeal suspension surgery, and tracheostoma revision. The diagnosis of a Killian Jamieson diverticulum was confirmed based on intra-operative findings, as the diverticular pouch was indeed seen to be located below the cricopharyngeal muscle. For patients with severe dysphagia that does not improve with swallowing rehabilitation, swallowing improvement surgery is an option. It aims to improve pre-operatively identified dysfunctional sites in the swallowing mechanism. It is important to always consider pharyngoesophageal diverticula as a possible cause of dysphagia so as not to miss the diagnosis. In this patient’s case, diverticulectomy was necessary to ensure the best possible outcomes in terms of improving his dysphagia.</p>\",\"PeriodicalId\":21944,\"journal\":{\"name\":\"SN Comprehensive Clinical Medicine\",\"volume\":\"6 1\",\"pages\":\"\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2024-07-27\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"SN Comprehensive Clinical Medicine\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1007/s42399-024-01713-2\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"SN Comprehensive Clinical Medicine","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1007/s42399-024-01713-2","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0

摘要

外侧髓质综合征(沃伦贝格综合征)和基里安-贾米森憩室都是导致吞咽困难的已知病症。在此,我们报告了首例在视频荧光屏吞咽检查中偶然发现的因沃伦贝格综合征和基利安-贾米森憩室而导致的严重吞咽困难病例。一名 66 岁的男性因严重吞咽困难转诊至我院,之前曾被诊断为 Wallenberg 综合征。术前检查发现,患者左侧咽部收缩力减弱、左侧声带麻痹、喉头抬高受损、吞咽时食管上括约肌松弛不良。此外,在进行视频荧光吞咽检查时,意外发现左侧食管在环咽水平以下有一个充满造影剂的外囊,表明存在咽喉食管憩室。患者接受了双侧环咽肌切开术和憩室切除术、喉悬吊手术和气管造口整复术。根据术中发现,憩室确实位于环咽肌下方,因此确诊为基里安-贾米森憩室。对于吞咽康复治疗无法改善的严重吞咽困难患者,可以选择吞咽改善手术。其目的是改善术前确定的吞咽机制功能障碍部位。必须始终将咽食管憩室视为吞咽困难的可能原因,以免漏诊。在这名患者的病例中,有必要进行憩室切除术,以确保在改善吞咽困难方面取得最佳效果。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

摘要图片

查看原文
分享 分享
微信好友 朋友圈 QQ好友 复制链接
本刊更多论文
Severe Dysphagia in a Patient with Wallenberg Syndrome and Killian Jamieson Diverticulum: A Case Report

Lateral medullary syndrome (Wallenberg syndrome) and Killian Jamieson diverticulum are both conditions known to cause dysphagia. Here, we present the first reported case of severe dysphagia due to Wallenberg syndrome and a Killian Jamieson diverticulum discovered incidentally during videofluoroscopic swallowing study. A 66-year-old male previously diagnosed with Wallenberg syndrome was referred to our hospital due to severe dysphagia. Pre-operative work-up revealed decreased left-sided pharyngeal contraction, left vocal fold paralysis, impaired laryngeal elevation, and poor upper esophageal sphincter relaxation during swallowing. Furthermore, on videofluoroscopic swallowing study, an incidental finding of a contrast-filled outpouching of the esophagus on the left, below the level of the cricopharyngeus, indicated the presence of a pharyngoesophageal diverticulum. The patient underwent bilateral cricopharyngeal myotomy with diverticulectomy, laryngeal suspension surgery, and tracheostoma revision. The diagnosis of a Killian Jamieson diverticulum was confirmed based on intra-operative findings, as the diverticular pouch was indeed seen to be located below the cricopharyngeal muscle. For patients with severe dysphagia that does not improve with swallowing rehabilitation, swallowing improvement surgery is an option. It aims to improve pre-operatively identified dysfunctional sites in the swallowing mechanism. It is important to always consider pharyngoesophageal diverticula as a possible cause of dysphagia so as not to miss the diagnosis. In this patient’s case, diverticulectomy was necessary to ensure the best possible outcomes in terms of improving his dysphagia.

求助全文
通过发布文献求助,成功后即可免费获取论文全文。 去求助
来源期刊
自引率
0.00%
发文量
0
期刊最新文献
Evaluation of Dyspnea, Physical Activity, Muscle Strength, and Quality of Life in Frail Older Adults with COPD Sonographic Changes in Median Nerve Diameter in Pregnant Women: An Indicator of Carpel Tunnel Syndrome Primary Health Care Workers Turnover intention and Organizational behavior: Systematic Review and Meta-analysis Ventilation/Perfusion Mismatch in a Child Following Cocaine Ingestion: Case Report Clinical Course of a Patient with Alpha-Heavy Chain Deposition Disease (a Case Report)
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
已复制链接
已复制链接
快去分享给好友吧!
我知道了
×
扫码分享
扫码分享
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1