2011, Number 2
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Revista Cubana de Cirugía 2011; 50 (2)
Epinephrine diverticulum
Moraima Emilia Vallés GME, Expósito ROR, Gaetano FC, Rey VYS
Language: Spanish
References: 12
Page: 223-228
PDF size: 208.41 Kb.
ABSTRACT
The epinephrine diverticulum due to the increase of intraesophageal pressure by
underlying motor alterations is a rare entity; it accounts for around the 10 % of all
esophageal diverticula. This is the case of a female patient aged 65 admitted in the
General Surgery Service presenting with obstructive jaundice by chronic
pancreatitis. A triple Catell's bypass was carried out and during the postoperative
course had vomiting containing non-digested fetid foods, ingested many hours or
days ago. Barium radiography of esophagus, stomach and duodenum was obtained
with a good contrast passage, verifying the presence of a very large epinephrine
diverticulum causing the symptoms. She was operated on using as approach route
a previous middle incision and trans-hiatal route. A vagotomy, diverticulectomy,
extended esophageal myotomy, anti-reflux procedure and temporary jejunostomy
for the early feeding. Course was favorable and patient remains asymptomatic.
REFERENCES
Michael H, Fisher RS. Treatment of epiphrenic and mid-esophageal diverticula. Curr Treat Options Gastroenterol. 2004;7(1):41-52.
Fasano NC, Levine MS, Rubesin SE, Redfern RO, Laufer I. Epiphrenic diverticulum: clinical and radiographic findings in 27 patients. Hepatogastroenterology. 2003;18(1):9-15.
Altorjay A, Botos B, Odor S, Sárkány A, Illés I, Varga I, Szilágyi A. Dilemmas arising from surgical treatment of epiphrenic diverticulum. Orv Hetil. 2005;146(19):959-63.
Varghese TK Jr, Marshall B, Chang AC, Pickens A, Lau CL, Orringer MB. Surgical treatment of epiphrenic diverticula: a 30-year experience. Ann Thorac Surg. 2007;84(6):1801-9.
Palanivelu C, Rangarajan M, Maheshkumaar GS, Senthilkumar R. Minimally invasive surgery combined with peroperative endoscopy for symptomatic middle and lower esophageal diverticula: a single institute's experience. Surg Laparosc Endosc Percutan Tech. 2008;18(2):133-8.
Lai ST, Hsu CP. Carcinoma arising from an epiphrenic diverticulum: a frequently misdiagnosed disease. Ann Thorac Cardiovasc Surg. 2007;13(2):110-3.
Granderath FA, Pointner R. Laparoscopic transhiatal resection of giant epiphrenic esophageal diverticulum. Dis Esophagus. 2007;20(4):353-7.
Lázár G, Szentpáli K, Paszt A. Minimally invasive surgical treatment for midesophageal and epiphrenic diverticula. Magy Seb. 2005;58(6):352-6.
Chen L, Walser EM, Schnadig V. Fatal hemorrhage secondary to ulcerated epiphrenic pseudodiverticulum. Arch Pathol Lab Med. 2006;130(6):867-70.
Kim KW, Berkmen YM, Auh YH, Kazam E. Diagnosis of epiphrenic esophageal diverticulum by computed tomography. J Comput Tomogr. 2005;12(1):25-8.
Guirroli E, Rizzetto C,Rampado S, Ancona E. Long-term outcome of operated and unoperated epiphrenic diverticula. J Gastrointest Surg. 2008;12(9):1485-90.
Zaninotto G, Portale G, Costantini M, Merigliano S, Valentini M, Pera M, et al. Incomplete esophageal myotomy and early recurrence of an epiphrenic diverticulum. Dis Esophagus. 2005;18(1):64-6.