Distal esophageal diverticulum secondary to a reflux-induced stricture.A white, diabetic, 72-year-old man with long-standing heartburn and globus came to the voice center with a 10-year history of dysphagia for solids and a several-year history of weight loss. Physical examination, including transnasal fiberoptic laryngoscopy, revealed that the man was thin and malnourished, but he did not exhibit any head and neck pathology Head and Neck pathology is the subspecialty of surgical pathology which deals with the diagnosis and characterization of neoplastic and non-neoplastic diseases of the neck, scalp, face, ears, paranasal sinuses, nasal cavity, oral cavity, salivary glands, pharynx, and larynx. . Transnasal esophagoscopy revealed a distal reflux-induced esophageal stricture ([sim]75%) that was located 36 cm from the nasal vestibule and 3 cm above the lower esophageal sphincter lower esophageal sphincter n. A ring of smooth muscle fibers at the junction of the esophagus and stomach. Also called cardiac sphincter. (figure). Esophagoscopy also detected a large diverticulum diverticulum Small pouch or sac formed in the wall of a major organ, usually the esophagus, small intestine, or large intestine (the most frequent site of problems). above the stricture, which was filled with corn from the patient's dinner the previous evening. There was no evidence of active esophagitis esophagitis /esoph·a·gi·tis/ (e-sof?ah-ji´tis) inflammation of the esophagus. chronic peptic esophagitis reflux e. . The patient's esophagus below the stricture appeared to be normal. The patient underwent in-office esophageal dilation, with Savary dilators placed over a guide wire under direct vision. Two months later, he remained free of dysphagia. |
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