Dahal Prajwal, Malla Saurav Krishna, Upadhyaya Rudra Prasad, Parajuli Sabina, Dhakal Natasha
Department of Radiology and Imaging, Grande International Hospital, Kathmandu, Nepal.
Department of Pathhology, Bir Hospital, Kathmandu, Nepal.
Radiol Case Rep. 2024 Jul 30;19(10):4417-4421. doi: 10.1016/j.radcr.2024.07.004. eCollection 2024 Oct.
Zenker's diverticulum (ZD) is an acquired, false, and pulsion diverticulum formed by the protrusion of mucosa and submucosa through Killian's dehiscence. The index case is a 91-year-old Nepali patient with a known history of diabetes mellitus, hypertension, rheumatic heart disease, and stage 4 chronic kidney disease, who has been experiencing dysphagia, halitosis, and chronic cough for 25 years. A computed tomography (CT) scan of the chest revealed an outpouching filled with air, fluid, and some solid contents, arising at the level of the cricoid cartilage and extending posteriorly to the esophagus, compressing it. A barium swallow test was performed for confirmation and revealed similar findings. The patient was counseled for surgery but declined due to old age and comorbidities. ZD is commonly seen in the geriatric population and patients with neuromuscular discordance. Barium swallow and CT chest scans can diagnose ZD, and surgery is the mainstay of treatment.
Zenker憩室（ZD）是一种后天性、假性、压力性憩室，由黏膜和黏膜下层通过Killian裂孔突出形成。首例病例是一名91岁的尼泊尔患者，有糖尿病、高血压、风湿性心脏病和4期慢性肾病病史，25年来一直有吞咽困难、口臭和慢性咳嗽症状。胸部计算机断层扫描（CT）显示一个充满空气、液体和一些固体内容物的袋状突出物，位于环状软骨水平，向后延伸至食管并对其造成压迫。进行了钡餐检查以确诊，结果显示了类似的发现。患者接受了手术咨询，但因年龄和合并症而拒绝。ZD常见于老年人群和神经肌肉不协调的患者。钡餐和胸部CT扫描可以诊断ZD，手术是主要的治疗方法。
