Nadir bir disfaji ve halitozis nedeni: Zenker divertikülü
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Dosyalar
Tarih
2018
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Medeniyet Medical Journal
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Öz: Çalışmamızda nadir görülen Zenker divertikülü tanısı alan ve tedavide eksternal yaklaşımla krikofarengeal miyotomi ve divertikülektomi yapılan olguyu sunuyoruz. Zenker divertikülü, özofagus üst sfinkterindeki spazma bağlı yükselen basınç nedeniyle, inferiyor konstrüktör kas ile krikofarengeus kası arasındaki zayıf noktadan farenks mukoza ve submukozasının dışarıya herniasyonuyla oluşur. Genellikle 7. ve 8. dekatlarda ve erkeklerde daha sık görülür. Hastalar sıklıkla disfaji, odinofaji, regürjitasyon, halitozis ve kronik öksürük yakınmaları ile başvururlar. Günümüzde Zenker divertikülü tedavisi büyük oranda belirlenmiş, ancak kesinlik kazanmamıştır. Tedavideki amaç divertikülü rezervuar olmaktan kurtararak, lümende düzgün bir akım oluşturmaktır. Günümüzde operasyon ve hastanede kalış sürelerinin ve komplikasyon oranlarının daha az olması nedeniyle endoskopik yaklaşım sıklıkla yeğlenmektedir. Bunun yanında, başarı oranlarının daha fazla olduğunu, endoskopi yapılamayacak ve büyük divertikülü olan hastalarda eksternal yaklaşımın uygulanması gerektiğini savunanlar da vardır. Tedavinin belirlenmesinde doktorun seçeneği, hastanın beklentisi, genel şartlar ve olanaklar dikkate alınmalıdır.
Abstract: In this article, we present a rare case which was diagnosed as Zenker’s diverticulum that was treated with external approach by performing cricopharyngeal myotomy and diverticulectomy. Zenker’s diverticulum occurs by herniation of the pharynx mucosa and submucosa from the weakened area between the cricopharyngeus and the inferior constructor muscles, because of the increased pressure created by the spasm of the upper esophageal sphincter. It is usually seen in 7-8th decades of life and more common among men. Patients usually present with complaints of dysphagia, odynophagia, regurgitation, halitosis, and chronic cough. Currently, treatment for Zenker’s diverticulum has been mostly defined, however it has not determined precisely. The purpose of the treatment is to create a uniform flow in the lumen by preventing the diverticulum from being a reservoir. Today, endoscopic approach is frequently preferred because of low complication rates and operation times and short hospital stay. However, some authors also advocate that external approach should be applied with greater success rates for a large diverticulum and in patients who can not undergo endoscopy. In determining the treatment, the preference of the doctor, the patient’s expectation, general conditions and possibilities should be considered.
Abstract: In this article, we present a rare case which was diagnosed as Zenker’s diverticulum that was treated with external approach by performing cricopharyngeal myotomy and diverticulectomy. Zenker’s diverticulum occurs by herniation of the pharynx mucosa and submucosa from the weakened area between the cricopharyngeus and the inferior constructor muscles, because of the increased pressure created by the spasm of the upper esophageal sphincter. It is usually seen in 7-8th decades of life and more common among men. Patients usually present with complaints of dysphagia, odynophagia, regurgitation, halitosis, and chronic cough. Currently, treatment for Zenker’s diverticulum has been mostly defined, however it has not determined precisely. The purpose of the treatment is to create a uniform flow in the lumen by preventing the diverticulum from being a reservoir. Today, endoscopic approach is frequently preferred because of low complication rates and operation times and short hospital stay. However, some authors also advocate that external approach should be applied with greater success rates for a large diverticulum and in patients who can not undergo endoscopy. In determining the treatment, the preference of the doctor, the patient’s expectation, general conditions and possibilities should be considered.
Açıklama
Yıl: 2018Cilt: 33Sayı: 1ISSN: 2149-2042 / 2149-4606Sayfa Aralığı: 57 - 60Metin Dili:Türkçe
Anahtar Kelimeler
Kaynak
Medeniyet Medical Journal
WoS Q Değeri
Scopus Q Değeri
Q4
Cilt
33
Sayı
1
Künye
YASLIKAYA S,KIZILAY A (2018). Nadir bir disfaji ve halitozis nedeni: Zenker divertikülü. Medeniyet Medical Journal, 33(1), 57 - 60. Doi: 10.5222/MMJ.2018.43403
