Congenital esophageal diverticulum - a case report and review of literature.

Zenker's Diverticulum (ZD) is a false diverticulum located in the posterior esophagus between the cricopharyngeus and inferior constrictor. Few cases have been reported in the pediatric population. Congenital esophageal diverticulum is commonly associated with additional esophageal anatomical deformities or iatrogenic injury in the early post-natal period. TD was born at 39 5/7 weeks gestational age and did well at home with the exception of "choking during feeds 2-4 times per day" with mild cyanosis. Flexible bronchoscopy performed under sedation revealed a retropharyngeal mass protruding towards the epiglottis resulting in upper airway obstruction. Esophogram demonstrated upper esophageal diverticulum. Patient underwent left neck dissection with cervical myotomy from the cricopharyngeus to the level of the thoracic inlet. A postoperative repeat esophogram illustrated resolution of the diverticulum. Currently, the patient is 9 months postoperative and is tolerating feeds by mouth, gaining weight and has no pulmonary symptoms. There have been a few reports of ZD in children occurring in combination with anatomical abnormalities or esophageal manipulation. This case is one of the youngest reported and occurs in a patient without any previous manipulation of the esophagus. This condition is exceedingly rare but should be included in the differential diagnosis for both pharyngoesophageal and tracheal symptoms.

Congenital true diverticula of the esophagus: a case report.

Pseudodiverticulosis secondary to gastroesophageal reflux is a common disease in adults, but true esophageal diverticula are rare in infants and children. A 5-year-old boy was well until the age of 1 1/2 years when he started vomiting. An upper gastrointestinal series showed two diverticula bulging from the posterior right side of the middle esophagus associated with slight hiatal hernia and short esophagus. Diverticulectomy, the Collis-Nissen antireflux procedure, and pyloroplasty were performed simultaneously through a left thoracoabdominal incision. Histological examination of the diverticula showed that the wall of each diverticulum consisted of a full-thickness of esophageal wall. Because there was no tracheal remnant in the diverticula, this lesion is more likely to be a true diverticulum than a duplication.

[A case report--congenital esophago-bronchial fistula with esophageal diverticulum].

Congenital esophago-bronchial fistula with diverticulum is rare, and in Japan only 29 cases have been reported. A 59-year-old man had suffered from recurrent pulmonary infections and often complained of coughing while drinking water during the previous two years. An UGI series for follow-up of gastric ulcer revealed an esophago-bronchial fistula, located between the mid-esophagus and B10 of the right lung. We resected the diverticulum and the fistulous tract with a partial excision of S10. Histological examination revealed that the squamous epithelium with the muscularis mucosa of the esophagus was smoothly connected to the columnar epithelium of the bronchus. Thus, we diagnosed this fistula as congenital, not acquired. Comparison of the previous UGI series before presenting symptoms with that performed at this admission showed the lengthening and thickening of this congenital fistula during the three-years period. We suspected that the influence of acquired factors may cause a congenital fistula to manifest various clinical symptoms.

[Congenital esophageal diverticulum]. / Divertículo esofágico congénito.

The congenital or acquired variety of esophageal diverticulum is a rare childhood disease. Reported is a case-study which deals with a five year old patient who arrived at our hospital complaining of a constricture at the cricopharyngeal level. A month later he returned to the hospital with dysphasia and regurgitation; the X-rays and endoscopic diagnosis showed stenosis of the esophagus and the presence of an esophageal diverticulum. Esophageal dilatations were carried out until an acceptable esophageal diameter was reached. Later on, the surgical removal of the diverticulum was performed without any complications. The histopathological study showed the congenital nature of the diverticulum. The patient's recovery went well and is currently considered as cured.

A rare type of intramural esophageal diverticulosis.

Benign stenosis of the mid-thoracic esophagus developed in a 28-yr-old man. At operation, the esophageal wall was adherent to the surrounding tissues at the level of the stricture, and the esophageal wall appeared scarred and felt hard. Pathologic examination of the resected specimen showed many submucosal cystic spaces associated with mucosal depressions. Based on these findings, a diagnosis of esophageal intramural diverticulosis was made. However, some cystic spaces ran parallel to the long axis of the esophagus, and one had penetrated the muscular layers and led into the inflammatory mass. Muscularis mucosa surrounded the cystic spaces, and inflammation was slight. These findings suggest that the etiology of the esophageal diverticula of this case was a congenital malformation.

Oesophageal diverticula: principles of management and appraisal of classification.

In this paper we review a consecutive series of 50 oesophageal diverticula, appraise clinical features and methods of management, and suggest an improvement on the World Health Organization classification. The link between oesophageal diverticula and motor disorders as assessed by oesophageal manometry is stressed. It is necessary to correct the functional disorder as well as the diverticulum if it is causing symptoms. A revised classification could be as follows: congenital--single or multiple; acquired--single (cricopharyngeal, mid-oesophageal, epiphrenic other) or multiple (for example, when cricopharyngeal and mid-oesophageal present together, or when there is intramural diverticulosis.

[Congenital pharyngo-oesophageal diverticulum in the newborn. Case report (author's transl)]. / Diverticule congénital pharyngo-oesophagien chez le nouveau-né. A propos d'une cas.

The Authors describe a case of congenital diverticulum of hypopharynx in a newborn. The lesion, early recognised, is successfull treated with surgical removal by a transcervical approach. The revision of the literature confirms the extreme rarity of this affection in the newborn and the correlated mortality if not early diagnosed and then confused with an atresia of the oesophagus it often simulates whose symptomatology.

[Digestive duplications affecting the pharynx or fistulae of the fourth endo-branchial pouch. Four cases (author's transl)]. / Duplications digestives de localisation pharyngée ou fistules de la quatrième poche endo-branchiale.

Four cases of children with recurrent latero-cervical epithelial cystic tumours which where identified as exceptional derivatives of the 4th endobranchial pouch on the basis of their connections with the pharynx and in particular the piriform fossa. The opportunity is taken to review the characteristics of equally rare digestive, duplications and congenital diverticula at a cervical and buccopharyngeal level. This diagnosis was made initially in the first of these cases.