Diffuse intramural diverticulum
Introduction
Introduction to diffuse esophageal wall diverticulum Diffuse esophageal diverticulum is a very rare benign lesion, first described by Mendl et al. (1960). The disease is characterized by a diffuse distribution of the esophageal wall with a size of 1 to 3 mm exogenous sac, which is accompanied by esophageal inflammation, fibrosis and thickening of the wall. More common in men aged 50 to 60, can also affect children and young people. Symptoms are mainly less severe dysphagia, intermittent, sometimes progressive. basic knowledge The proportion of illness: the incidence is around 2-5% Susceptible people: no special people Mode of infection: non-infectious Complications: dysphagia, bad breath, pneumonia, atelectasis, lung abscess
Cause
Diffuse esophageal wall diverticulum
Most of the initial asymptomatic, or a sense of foreign body pharyngeal and short-term food stagnation, increased mouth and mouth. With the expansion of the diverticulum and the difficulty of emptying, it can show slow progressive difficulty of swallowing, snoring, returning undigested food and mucus, and has a certain relationship with body position changes. The pharyngeal esophageal diverticulum occurs in the weak area between the inferior pharyngeal muscle and the pharyngeal muscle, and the symptoms are obvious and gradually worsened. Some patients have a full neck or a mass at the time of eating, mostly on the left side, which can be used to massage the diverticulum. You can hear snoring when you drink water. More bad breath.
Prevention
Diffuse esophageal wall diverticulosis prevention
Drink at least 6 glasses of water a day to prevent constipation. If you are already constipated, a special formula of herbal tea for plum, plum juice or constipation can be used as a natural laxative.
Keeping a low-fat diet, fat can slow down the passage of food through the intestines. Perform some food-sensitive tests to find foods that are irritating to your digestive system and should be avoided.
Complication
Diffuse esophageal wall diverticulum complications Complications, swallowing, bad breath, pneumonia, atelectasis
Due to the accumulation of food, the diverticulum will continue to increase and gradually fall, which is not conducive to the discharge of the accumulation of the chamber, so that the opening of the diverticulum is facing the lower part of the throat. The swallowed food first enters the diverticulum and returns to the flow. Difficulties, and progressive progressive, some patients also have bad breath, nausea, loss of appetite and other symptoms. Some suffer from malnutrition and weight loss due to eating difficulties. In the absence of treatment, if the diverticulum gradually increases, the accumulated food and secretions begin to increase, sometimes automatically returning to the oral cavity, occasionally causing aspiration. The result of aspiration can lead to complications such as pneumonia, atelectasis or lung abscess. Hemorrhage, perforation and complication are less common.
Symptom
Diffuse esophageal wall diverticulum symptoms common symptoms dysphagia esophageal reflux symptoms esophageal wall thickening
The disease is more common in men aged 50-60 years old, but also affects children and young people. The symptoms are mainly less severe dysphagia. The symptoms are intermittent and sometimes progressive, and about one-third of patients have stomach. Symptoms of esophageal reflux and esophageal stricture.
Examine
Diffuse esophageal wall examination
1. Barium meal examination: found in the esophageal lumen multiple, such as long-necked flask-shaped or button-shaped small sac, an average of 1 ~ 3cm, showing a scattered or localized distribution, 90% of cases of esophagus has a certain degree of stenosis or The esophageal motor function of this part is abnormal, showing a strong adductive contraction or a third contraction. The esophagus is obviously narrowed, and the pseudo-diverticulum is also increased. The esophageal stenosis is related to the formation of the diverticulum. The increase of the intraluminal pressure in this part promotes the formation of the diverticulum. .
2. Endoscopy: 2/3 of the patients had inflammatory changes in the esophagus, and the diverticulum with smaller openings was usually invisible.
3. CT examination: visible diffuse irregularities in the esophageal lumen.
Diagnosis
Diagnosis and diagnosis of diffuse esophageal wall diverticulum
According to the patient's progressive dysphagia combined with gastroesophageal reflux symptoms, barium meal and endoscopy can confirm the diagnosis.
Sometimes it is easy to be confused with esophageal cancer, and it is feasible to identify endoscopy.
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