| Autor: |
Fujinaga, Atsuro, Shibata, Tomotaka, Etoh, Tsuyoshi, Tada, Kazuhiro, Suzuki, Kosuke, Nishiki, Kohei, Ogawa, Katsuhiro, Kono, Yohei, Hiratsuka, Takahiro, Akagi, Tomonori, Ueda, Yoshitake, Toujigamori, Manabu, Shiroshita, Hidefumi, Shiraishi, Norio, Inomata, Masafumi |
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| Zdroj: |
Surgical Case Reports; 6/29/2020, Vol. 6 Issue 1, p1-5, 5p |
| Abstrakt: |
Background: An esophageal diverticulum is rare and is frequently associated with esophageal motility disorders. Jackhammer esophagus is also rare, is characterized by esophageal hypercontraction, and comprises 4.1% of esophageal motility disorders. Here, we report a case of a patient successfully treated by laparoscopic transhiatal surgery for an epiphrenic esophageal diverticulum derived from a jackhammer esophagus diagnosed with high-resolution manometry (HRM). Case presentation: The patient was a 78-year-old man who presented to the hospital with dysphagia. A diverticulum was detected in the lower part of his esophagus by upper gastrointestinal endoscopy. HRM was performed to investigate esophageal motility disorders. His integrated relaxation pressure was normal at 25.9 (< 26) mmHg, but his distal contractile integral (DCI) was very high at 21,464 (1500–13,000) mmHg s cm. Esophageal peristalsis was preserved. Therefore, the patient was diagnosed as having an epiphrenic esophageal diverticulum derived from a jackhammer esophagus for which laparoscopic transhiatal diverticulectomy and Heller-Dor procedure were performed. The postoperative course was uneventful. His symptoms improved, and the level of DCI also returned to a normal level of 3867 mmHg s cm at 2 months after the operation. Conclusion: Laparoscopic transhiatal diverticulectomy and esophagomyotomy can be useful procedures for an epiphrenic esophageal diverticulum derived from a jackhammer esophagus due to their lower invasiveness. [ABSTRACT FROM AUTHOR] |
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