Document Detail

Zenker's diverticulum in the elderly: a neurologic etiology?
MedLine Citation:
PMID:  9731825     Owner:  NLM     Status:  MEDLINE    
Though described in 1769, the etiology of Zenker's diverticulum remains unclear. Various primary esophageal motor disorders have been proposed, but no consistent manometric pattern or anatomic etiology has been uniformly recognized. An association with clinical neurologic disease at our institution prompted a review of 12 cases of Zenker's diverticulum in patients over 60 years of age, treated in the last 8 years. Nine patients (75%) underwent cricopharyngeus myotomy and diverticulectomy, with uniformly good results. Ten patients (83%) had an associated neurologic disorder, substantiated by cranial CT or MRI, in most cases. A wide range of neurologic problems were identified, but a strong trend toward brainstem or basilar lesions was present. As expected, the etiology of the neurologic abnormality in most patients in this group was cerebrovascular disease, but two patients had peripheral neuropathies. We suggest that the etiology of Zenker's diverticulum in the elderly may be neurologic in origin. Esophageal motor disorders, including incomplete upper esophageal sphincter opening and increased hypopharyngeal pressures, which may result in Zenker's diverticulum, may be a manifestation of central or peripheral neurologic disease in the elderly.
D N Walters; J W Battle; C A Portera; J D Blizzard; I W Browder
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The American surgeon     Volume:  64     ISSN:  0003-1348     ISO Abbreviation:  Am Surg     Publication Date:  1998 Sep 
Date Detail:
Created Date:  1998-09-24     Completed Date:  1998-09-24     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0370522     Medline TA:  Am Surg     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  909-11     Citation Subset:  IM    
Department of Surgery, James H. Quillen College of Medicine, East Tennessee State University, Johnson City 37614, USA.
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MeSH Terms
Aged, 80 and over
Basilar Artery / pathology
Brain Stem / blood supply
Cerebral Infarction / complications
Cerebrovascular Disorders / complications*,  diagnosis
Esophageal Motility Disorders / complications
Esophagus / physiopathology
Magnetic Resonance Imaging
Middle Aged
Peripheral Nervous System Diseases / complications
Pharyngeal Muscles / surgery
Tomography, X-Ray Computed
Zenker Diverticulum / etiology*,  pathology,  surgery

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