Ito Ayaka, Kitazono Masaki, Fujita Makoto, Ikeda Naotaka, Eguchi Mayumi, Oyama Tomohiro, Uchiyama Shuichiro, Toyosaki Ryoichi, Suenaga Toyokuni
Department of Surgery, Fujita Health University Hospital, Toyoake City, Japan.
Department of Surgery, Nanpuh Hospital, Kagoshima City, Japan.
J Surg Case Rep. 2023 Apr 12;2023(4):rjad184. doi: 10.1093/jscr/rjad184. eCollection 2023 Apr.
The patient is a 60-year-old female with a history of multiple times of recurrences of an esophageal diverticulum. She was referred for a diagnosis of persistent dysphagia and vomiting. Balloon dilation did not improve the symptoms; thus, she was referred for surgery. Esophageal fluoroscopy revealed a 5 cm diverticulum. There was no significant change in the size before and after dilation. Gastrointestinal endoscopy revealed a diverticulum in the lower esophagus, with a residue accumulation. The esophagus directly below the diverticulum was narrowed. The patient was diagnosed with recurrent lower esophageal diverticulum and underwent surgery. The operative findings showed poor coloration of the gastric fundus surrounding operated before by Nissen's method, so the patient underwent lower esophagogastric resection and interstitial jejunal reconstruction. The postoperative course was uneventful and discharged on the 19th day. She is 6 years postoperatively and gained six kg compared to her preoperative weight. She has remained in excellent health.
该患者为60岁女性，有食管憩室多次复发史。因持续性吞咽困难和呕吐前来就诊以明确诊断。球囊扩张未能改善症状，因此她被转诊接受手术治疗。食管透视显示有一个5厘米的憩室。扩张前后大小无明显变化。胃肠内镜检查发现食管下段有一个憩室，有残留物积聚。憩室正下方的食管变窄。患者被诊断为复发性食管下段憩室并接受了手术。手术所见显示，之前接受过nissen法手术的胃底周围色泽不佳，因此患者接受了食管下段胃切除术和空肠间置重建术。术后过程顺利，于第19天出院。术后6年，她比术前体重增加了6公斤。她一直保持着良好的健康状态。
