Guoyao Sun, Wen Jia, Zhuo Yang, Jiao Liu, Yong Sun
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引用次数: 0
摘要
咽道憩室,包括最常见的Zenker憩室、Killian-Jamieson憩室和罕见的Laimer憩室,需要准确鉴别才能正确治疗。本病例报告探讨了内镜下超声(EUS)在基利安-贾米森憩室治疗中的诊断和治疗价值。病例介绍一名57岁的女性,在过去的三个月里出现固体吞咽困难。食管胃十二指肠镜(EGD)显示食管憩室位于食管上括约肌下方。EUS测憩室大小为1.0 cm × 1.4 cm,证实未见固有肌层,排除Laimer憩室。患者接受了柔性内窥镜鼻中隔切开术(FESD),无任何不良事件。术后三个月的钡餐食道造影显示左侧基利安-贾米森憩室。结论本病例强调内镜下钡餐及EUS检查对准确诊断基利安-贾米森憩室的重要性。结果表明,这种综合诊断方法提高了诊断准确性,指导了治疗,为咽食管憩室的治疗提供了新的思路。
Endoscopic Treatment and Considerations for a Rare of Killian-Jamieson Diverticulum: A Case Report
Background
Pharyngoesophageal diverticulum, including the most common Zenker's diverticulum, Killian-Jamieson diverticulum, and the rarer Laimer's diverticulum, require accurate differentiation for proper treatment. This case report explores the endoscopic features and the diagnostic and therapeutic value of endoscopic ultrasound (EUS) in the management of Killian-Jamieson diverticulum.
Case Presentation
A 57-year-old woman presented with dysphagia for solids over the past three months. Esophagogastroduodenoscopy (EGD) revealed an esophageal diverticulum located below the upper esophageal sphincter. EUS measured the diverticulum to be 1.0 cm by 1.4 cm and confirmed the absence of muscularis propria, thereby ruling out Laimer's diverticulum. The patient underwent flexible endoscopic septum division (FESD) without any adverse events. A barium esophagram three months post-surgery indicated a left-sided Killian-Jamieson diverticulum.
Conclusion
This case highlights the importance of combining endoscopic features with barium swallow and EUS for accurate diagnosis of Killian-Jamieson diverticulum. The results suggest that such an integrated diagnostic approach enhances diagnostic accuracy and guides treatment, offering insights into the management of pharyngoesophageal diverticulum.