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Type:
Educational Exhibit
Keywords:
Gastrointestinal tract, Ear / Nose / Throat, Conventional radiography, Fluoroscopy, Ultrasound, Surgery, Technical aspects, Diverticula, Eating disorders
Authors:
S. pardo, A. M. Maiorana, F. Cremona, F. Cupido, S. Poma, G. Agnello; Palermo/IT
DOI:
10.1594/ecr2014/C-0561
Learning objectives
The present report describe a clinical case of old patient with symptomatic giant Killian-Jamieson diverticulum.
A KJD,
described first by Killian,
is a rare form of hypopharyngeal diverticulum (unfamiliar cervical esophageal disease)1.
This outpouching generally protrudes through a muscular gap in the antero-lateral wall of the proximal esophagus,
on the lateral pharyngoesophageal junction area (the Killian-Jamieson space) below the cricopharyngeal muscle and lateral to the longitudinal muscle of the esophagus1,
2 and 3.
This rare disease entity is anatomically distinct from the more commonly known Zenker’s diverticulum (ZD - muscular gap in the posterior portion of the cricopharyngeus,
the Killian’s triangle),
which is the most commonly encountered diverticulum of the cervical esophagus1,3,4 and 5.
Studies describe KJDiverticula like seldom larger than 1.5 cm and usually asymptomatics1;
we report a rare case of symptomatic giant KJD with maximal dimension of 5 cm in a 97 year old female patient.
The Authors emphasize the importance of an accurate clinical and imaging studies,
as a fundamental act for exclude other cervical esophageal disease.
Literature regarding Killian-Jamieson diverticulum and its suggested management is scarce3 and to date,
various treatment modality have been attempted,
but only traditional surgical treatment has been recommended for a symptomatic giant KJD due to the concern of possible nerve injury.
We present here a rare case of a symptomatic KJD that was successfully treated with cervical incision,
esophagomyotomy and diverticulopexy.
Following surgery,
the patient’s disease was resolved and she recovered well.