Esophageal diverticulum is a fairly common disease that occurs most often in older people, but can develop in those who suffer from various diseases of the digestive system( peptic ulcer and duodenal ulcer, cholecystitis).Its official name is the protrusion of the esophagus. Such bulging communicates with the esophageal lumen and can develop in any part of it. However, the most common diverticulum is bifurcation, pharyngeal-esophageal and epiphrenic.
The vast majority of diverticula are single. It is much less common to detect multiple clusters.
Diverticul is found mainly in men over 50 years of age. There is an opinion that it develops as a result of aging and thinning of tissues.
Dysbacteriosis of the esophagus of an innate character is infrequent and is often associated with the congenital muscular weakness of the esophageal wall sections.
The esophageal diverticulum of the acquired character can develop in the following situations:
- in inflammatory processes that are likely to occur in the esophagus( esophagospasm, achalasia of the cardia), if it enters the gastro-acid medium, inflammation of the lymph nodes( histoplasmosis);
- if there are injuries of a surgical nature that violate the integrity of the muscular shell. They also contribute to the appearance of protrusion;
- In addition, diverticulum can be a consequence of disruption of the normal functioning of the esophagus, the appearance of spastic contractions and contractions of the membrane;
- sometimes the wall of the esophagus splices with a number of located organs. Usually it is the lymph nodes of the mediastinum, which have undergone inflammation. In this case, the esophageal wall stretches in the direction of this organ, and a protrusion develops on the weakened wall;
Quite often the listed conditions are observed simultaneously, which increases the risk of diverticula appearance.
Symptoms of the esophagus diverticulum
It is almost impossible to determine when exactly this saccular formation occurs on the esophageal wall. For several years, the patient can notice only minor signs: a sore throat, excessive salivation, cough after eating( a filled diverticulum exerts pressure, causing similar difficulties), a feeling of dryness in the throat, often the expectoration of freshly eaten food.
The diverticulum of the esophagus looks like a large, rounded formation. The contours are smooth, when swallowed, it moves upward. If inflammatory processes occur in the diverticulum, then some discomfort can be felt, and if the protrusion is localized in the thoracic zone of the esophagus, then it is possible to swallow. Diverticulum in this case has low displacement and has uneven contours. To detect such a diverticulum can only be in lateral position when swallowing. The diverticulum located in the lower part of the esophagus can be palpated. However, this is only possible when it is filled, or if inflammatory processes have already begun to take place in it. In clinical conditions, X-rays are taken in various positions of the body for the best examination of the affected area.
Esophageal diverticulum: treatment
As a rule, in most cases the diverticulum does not cause any special complications in the patient and the treatment of diverticulitis passes quite effectively. However, if an inflammatory process is observed, then excision is performed. Subsequently, the wall of the esophagus is restored. A small diverticulum can simply "screw" into the esophagus, and the wall is strengthened with sutures and local tissues.
The age of the patient affects the treatment. In cases where, in addition to this disease, there are other, more severe, and the patient's age does not allow the operation to be carried out, permanent monitoring is appointed.