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胃底折叠术20年后膈上食管憩室的非典型表现:一例病例报告及文献复习

Atypical presentation of an epiphrenic esophageal diverticulum 20 years post fundoplication: a case report and review.

作者信息

Tasabehji Dana, Jarrah Mohammad, Mokadem Mohamad

机构信息

Division of Gastroenterology and Hepatology, Department of Internal Medicine, University of Iowa Hospitals and Clinics, Iowa City, IA 52242, United States.

Fraternal Order of Eagles Diabetes Research Center, Iowa City, IA 52242, United States.

出版信息

J Surg Case Rep. 2024 May 29;2024(5):rjae316. doi: 10.1093/jscr/rjae316. eCollection 2024 May.

Abstract

Esophageal diverticulum is a rare condition characterized by the herniation of the esophageal mucosa outside the esophageal wall. Here, we explore the prevalence of ED and its associated esophageal dysmotility. We also shed light on the potential impact of previous surgical interventions, such as Nissen's fundoplication, on the development of ED. This manuscript presents the case of a 72-year-old woman with a history of Nissen's fundoplication surgery who experienced worsening symptoms of dysphagia, heartburn and postprandial cough. Despite exhibiting a normal motility pattern, upper endoscopy revealed a large epiphrenic esophageal diverticulum. The patient underwent successful surgical resection with myotomy, resulting in the resolution of symptoms with no complications. This case highlights the rarity of symptomatic ED and the need to recognize it while choosing the optimal treatment modality.

摘要

食管憩室是一种罕见病症,其特征为食管黏膜疝出至食管壁外。在此,我们探究食管憩室(ED)的患病率及其相关的食管动力障碍。我们还阐明了既往手术干预(如nissen胃底折叠术)对ED发生发展的潜在影响。本手稿介绍了一名72岁女性病例,该患者有nissen胃底折叠术手术史,出现吞咽困难、烧心和餐后咳嗽等症状加重。尽管其动力模式正常,但上消化道内镜检查发现一个巨大的膈上食管憩室。患者成功接受了伴肌切开术的手术切除,症状得以缓解且无并发症。该病例凸显了有症状的ED的罕见性以及在选择最佳治疗方式时识别它的必要性。

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