| Zenker's diverticulum in the elderly: a neurologic etiology? | |
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MedLine Citation:
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PMID: 9731825 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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D N Walters; J W Battle; C A Portera; J D Blizzard; I W Browder |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: The American surgeon Volume: 64 ISSN: 0003-1348 ISO Abbreviation: Am Surg Publication Date: 1998 Sep |
Date Detail:
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Created Date: 1998-09-24 Completed Date: 1998-09-24 Revised Date: 2004-11-17 |
Medline Journal Info:
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Nlm Unique ID: 0370522 Medline TA: Am Surg Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 909-11 Citation Subset: IM |
Affiliation:
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Department of Surgery, James H. Quillen College of Medicine, East Tennessee State University, Johnson City 37614, USA. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Aged Aged, 80 and over Basilar Artery / pathology Brain Stem / blood supply Cerebral Infarction / complications Cerebrovascular Disorders / complications*, diagnosis Esophageal Motility Disorders / complications Esophagus / physiopathology Humans Magnetic Resonance Imaging Male Manometry Middle Aged Peripheral Nervous System Diseases / complications Pharyngeal Muscles / surgery Pressure Tomography, X-Ray Computed Zenker Diverticulum / etiology*, pathology, surgery |
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