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Misso KK, Koipapi S, Chilonga K. Pediatric esophageal diverticulum following button batter ingestion. A case report. Int J Surg Case Rep 2023; 110:108665. [PMID: 37634438 PMCID: PMC10509801 DOI: 10.1016/j.ijscr.2023.108665] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2023] [Revised: 08/11/2023] [Accepted: 08/11/2023] [Indexed: 08/29/2023] Open
Abstract
INTRODUCTION AND SIGNIFICANCE Foreign body ingestion is a frequent and potentially life-threatening concern in children, with button batteries being the second most frequently ingested object trailing coins. The mechanical and chemical impact of foreign objects on delicate esophageal lumen poses a grave concern. CASE PRESENTATION Herein, we unveil a compelling case of a two-year-old girl who suffered from difficulty in swallowing, weight loss, and frequent chest infections. A chest X-ray revealed a halo sign within the confines of her thoracic esophagus. However, the formidable challenge of extensive inflammation greatly hindered visibility during esophagoscopy, leading to an imperative decision of thoracotomy. The surgical exploration uncovered an esophageal diverticulum, skillfully managed with a conservative approach. Three months postoperatively, she resumed regular feeds without chest symptoms. DISCUSSION Foreign body ingestion is predominantly among children below four years, with button batteries being among the frequent objects involved. Endoscopic retrieval is an effective and less morbid procedure for foreign body retrieval. Esophageal diverticula following button battery ingestion have rarely been reported. CONCLUSION Timely diagnosis and effective management of esophageal foreign bodies are crucial, as chemical reactions from button batteries can commence within two hours of ingestion. Swift and decisive actions, coupled with less morbid procedures such as endoscopic retrieval should be prioritized in the management.
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Affiliation(s)
- Kennedy Kisengo Misso
- Department of General Surgery, Kilimanjaro Christian Medical Centre, Tanzania; Department of General Surgery, Kilimanjaro Christian Medical University College, Tanzania.
| | - Sengua Koipapi
- Department of General Surgery, Kilimanjaro Christian Medical Centre, Tanzania; Department of General Surgery, Kilimanjaro Christian Medical University College, Tanzania
| | - Kondo Chilonga
- Department of General Surgery, Kilimanjaro Christian Medical Centre, Tanzania; Department of General Surgery, Kilimanjaro Christian Medical University College, Tanzania
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Prevost AS, Bannoura S, Ngan BY, Siu JM, Ziai H, Campisi P. Pseudodiverticulum of the Cervical Esophagus With Remnant of Branchial Tissues in a Newborn: A Case Report. Pediatr Dev Pathol 2022; 25:330-333. [PMID: 34996321 DOI: 10.1177/10935266211066398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Congenital pseudodiverticula of the esophagus are very rare. This case report describes the presentation, management and histopathology of a peudodiverticulum of the cervical esophagus in a neonate. The infant presented with respiratory distress and a right neck mass that required surgical excision. Pathology revealed a pseudodiverticulum that contained ectopic thymic, thyroid, and parathyroid tissue within the wall of the lesion. The presence of ectopic tissues of branchial origin and an aberrant right subclavian artery suggest an error in branchial development and neural crest cell migration.
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Affiliation(s)
- Anne-Sophie Prevost
- Department of Otolaryngology-Head & Neck Surgery, 7979Hospital for Sick Children, University of Toronto, Toronto, ON, Canada
| | - Sami Bannoura
- Department of Pediatric Laboratory Medicine, Division of Pathology, 7979Hospital for Sick Children, Toronto, ON, Canada
| | - Bo-Yee Ngan
- Department of Pediatric Laboratory Medicine, Division of Pathology, 7979Hospital for Sick Children, Toronto, ON, Canada
| | - Jennifer M Siu
- Department of Otolaryngology-Head & Neck Surgery, 7979Hospital for Sick Children, University of Toronto, Toronto, ON, Canada
| | - Hedyeh Ziai
- Department of Otolaryngology-Head & Neck Surgery, 7979Hospital for Sick Children, University of Toronto, Toronto, ON, Canada
| | - Paolo Campisi
- Department of Otolaryngology-Head & Neck Surgery, 7979Hospital for Sick Children, University of Toronto, Toronto, ON, Canada
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Arenas-Rojas AM, Pineda-Parra AM, Walteros-Cárdenas J, Villamizar-Durán LI. Preescolar con divertículo de Zenker y hallazgo intraoperatorio de cuerpo extraño esofágico. REVISTA COLOMBIANA DE CIRUGÍA 2022. [DOI: 10.30944/20117582.887] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Introducción. El divertículo de Zenker es una evaginación sacular ciega que puede presentarse a nivel faringoesofágico. No se conoce exactamente su incidencia en la edad pediátrica, constituyendo una patología muy infrecuente. La sintomatología es inespecífica, lo que dificulta el diagnóstico precoz y determina un mayor riesgo de complicaciones asociadas.
Caso clínico. Paciente preescolar femenina con cuadro recurrente de emesis con deshidratación, posteriormente asociado a disfagia, a quien se le diagnosticó un divertículo de Zenker. Se realizó tratamiento quirúrgico con hallazgo intraoperatorio de dilatación esofágica, un área de estenosis secundaria al hallazgo incidental de un cuerpo extraño y divertículo de Zenker en la región lateral del esófago dilatado.
Discusión. Esta patología es extremadamente rara, pero se debe tener en cuenta dentro de los diagnósticos diferenciales en pacientes con sintomatología faringo-esofágica.
Conclusión. Se presenta una preescolar sin antecedente de procedimientos esofágicos o malformaciones congénitas asociadas con diagnóstico de un divertículo de Zenker y dilatación esofágica por un cuerpo extraño, tratada quirúrgicamente de forma exitosa.
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Lanzoni G, Sembenini C, Gastaldo S, Leonardi L, Bentivoglio VP, Faggian G, Bosa L, Gaio P, Cananzi M. Esophageal Dysphagia in Children: State of the Art and Proposal for a Symptom-Based Diagnostic Approach. Front Pediatr 2022; 10:885308. [PMID: 35813384 PMCID: PMC9263077 DOI: 10.3389/fped.2022.885308] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2022] [Accepted: 06/06/2022] [Indexed: 11/29/2022] Open
Abstract
Pediatric esophageal dysphagia (PED) is an infrequent condition that can be determined by a large number of disorders. The etiologic diagnosis is challenging due to overlapping clinical phenotypes and to the absence of pediatric diagnostic guidelines. This review aims to summarize the most relevant causes of ED during childhood, highlight the clinical scenarios of PED presentation and discuss the indications of available diagnostic tools. Available information supports that PED should always be investigated as it can underlie life-threatening conditions (e.g., foreign body ingestion, mediastinal tumors), represent the complication of benign disorders (e.g., peptic stenosis) or constitute the manifestation of organic diseases (e.g., eosinophilic esophagitis, achalasia). Therefore, the diagnosis of functional PED should be made only after excluding mucosal, structural, or motility esophageal abnormalities. Several clinical features may contribute to the diagnosis of PED. Among the latter, we identified several clinical key elements, relevant complementary-symptoms and predisposing factors, and organized them in a multi-level, hierarchical, circle diagram able to guide the clinician through the diagnostic work-up of PED. The most appropriate investigational method(s) should be chosen based on the diagnostic hypothesis: esophagogastroduodenoscopy has highest diagnostic yield for mucosal disorders, barium swallow has greater sensitivity in detecting achalasia and structural abnormalities, chest CT/MR inform on the mediastinum, manometry is most sensitive in detecting motility disorders, while pH-MII measures gastroesophageal reflux. Further studies are needed to define the epidemiology of PED, determine the prevalence of individual underlying etiologies, and assess the diagnostic value of investigational methods as to develop a reliable diagnostic algorithm.
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Affiliation(s)
- Gloria Lanzoni
- School of Specialty in Pediatrics, University Hospital of Padova, Padua, Italy.,Unit of Pediatric Gastroenterology, Digestive Endoscopy, Hepatology and Care of the Child With Liver Transplantation, Department of Women's and Children's Health, University Hospital of Padova, Padua, Italy
| | - Camilla Sembenini
- School of Specialty in Pediatrics, University Hospital of Padova, Padua, Italy
| | - Stefano Gastaldo
- School of Specialty in Pediatrics, University Hospital of Padova, Padua, Italy
| | - Letizia Leonardi
- School of Specialty in Pediatrics, University Hospital of Padova, Padua, Italy
| | | | - Giovanna Faggian
- Unit of Pediatric Gastroenterology, Digestive Endoscopy, Hepatology and Care of the Child With Liver Transplantation, Department of Women's and Children's Health, University Hospital of Padova, Padua, Italy
| | - Luca Bosa
- Unit of Pediatric Gastroenterology, Digestive Endoscopy, Hepatology and Care of the Child With Liver Transplantation, Department of Women's and Children's Health, University Hospital of Padova, Padua, Italy
| | - Paola Gaio
- Unit of Pediatric Gastroenterology, Digestive Endoscopy, Hepatology and Care of the Child With Liver Transplantation, Department of Women's and Children's Health, University Hospital of Padova, Padua, Italy
| | - Mara Cananzi
- School of Specialty in Pediatrics, University Hospital of Padova, Padua, Italy.,Unit of Pediatric Gastroenterology, Digestive Endoscopy, Hepatology and Care of the Child With Liver Transplantation, Department of Women's and Children's Health, University Hospital of Padova, Padua, Italy
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Rubel C S, Fluxa G F, Fabre P, Ferraris M, Ramirez A. Endoscopic esophageal septotomy. VideoGIE 2018; 3:341-342. [PMID: 30402578 PMCID: PMC6205304 DOI: 10.1016/j.vgie.2017.12.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
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Wang ZM, Zhang SC, Teng X. Esophageal diverticulum serves as a unique cause of bronchoesophageal fistula in children: A case report. Medicine (Baltimore) 2017; 96:e9492. [PMID: 29390593 PMCID: PMC5758295 DOI: 10.1097/md.0000000000009492] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
RATIONALE Most of the esophageal diverticulums are congenital traction instead of in childhood. In most conditions, esophageal diverticulums are free of any symptoms. As one of the rare entity, esophageal diverticulum can also result in bronchoesophageal fistula. PATIENT CONCERNS A 10-year-old girl was admitted due to a 2-month history of cough and choking after drinking, and fever for 3 days. No symptoms when taking solid food were found. DIAGNOSES By esophagogram, 3-dimensional computed tomography and esophagoscopy, an esophageal diverticulum was demonstrated in the middle esophagus with a bronchoesophageal fistula visualized. Then the diagnoses of esophageal diverticulum and bronchoesophageal fistula were established. INTERVENTIONS A regular trans-anterolateral thoracotomy was carried out under general anesthesia with patient lying on the right side. The diverticulum was then removed and the fistulous tract was closed. OUTCOMES The girl discharged on the 14th postoperative day and received a regular monthly follow-up, at present, no recurrence was found. LESSONS Bronchoesophageal fistula may be a complication of esophageal diverticula, and should be considered in cases of unexplained cough or recurrent pneumonia.
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Affiliation(s)
- Zhi-Ming Wang
- Department of Oral and Maxillofacial Surgery Department of Pediatric Gastroenterology, Shengjing Hospital of China Medical University, Shenyang, P.R. China
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Watanabe T, Shimizu T, Takahashi M, Sato K, Ohno M, Fuchimoto Y, Maekawa T, Arai K, Mizutari K, Morimoto N, Kanamori Y. Cricopharyngeal achalasia treated with myectomy and post-operative high-resolution manometry. Int J Pediatr Otorhinolaryngol 2014; 78:1182-5. [PMID: 24845265 DOI: 10.1016/j.ijporl.2014.04.036] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2014] [Revised: 04/16/2014] [Accepted: 04/20/2014] [Indexed: 10/25/2022]
Abstract
Cricopharyngeal achalasia is an uncommon cause of dysphagia in neonates or children. A nine-year-old female patient was referred to us with a long history of dysphagia, recurrent pulmonary infection and growth stunting. A gastrostomy was introduced to improve her nutritional condition and to minimize potential inflammation in the pharynx. Subsequently, cervical cricopharyngeal myectomy was conducted. The surgical intervention allowed prompt resolution of symptoms without complications. High-resolution manometry post myectomy demonstrated a significant reduction in upper esophageal pressure together with proper relaxation at deglutition. The patient was able to consume solid food and liquid normally, and remained asymptomatic without medications six months after the surgery.
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Affiliation(s)
- Toshihiko Watanabe
- Division of Surgery, Department of Surgical Specialties, National Center for Child Health and Development, Tokyo, Japan.
| | - Takahiro Shimizu
- Division of Surgery, Department of Surgical Specialties, National Center for Child Health and Development, Tokyo, Japan
| | - Masataka Takahashi
- Division of Surgery, Department of Surgical Specialties, National Center for Child Health and Development, Tokyo, Japan
| | - Kaori Sato
- Division of Surgery, Department of Surgical Specialties, National Center for Child Health and Development, Tokyo, Japan
| | - Michinobu Ohno
- Division of Surgery, Department of Surgical Specialties, National Center for Child Health and Development, Tokyo, Japan
| | - Yasushi Fuchimoto
- Division of Surgery, Department of Surgical Specialties, National Center for Child Health and Development, Tokyo, Japan
| | - Takanobu Maekawa
- Division of Pediatrics, Department of General Pediatrics and Interdisciplinary Medicine, National Center for Child Health and Development, Tokyo, Japan
| | - Katsuhiro Arai
- Division of Gastroenterology, Department of Medical Subspecialties, National Center for Child Health and Development, Tokyo, Japan
| | - Kunio Mizutari
- Division of Otolaryngology, Department of Surgical Specialties, National Center for Child Health and Development, Tokyo, Japan
| | - Noriko Morimoto
- Division of Otolaryngology, Department of Surgical Specialties, National Center for Child Health and Development, Tokyo, Japan
| | - Yutaka Kanamori
- Division of Surgery, Department of Surgical Specialties, National Center for Child Health and Development, Tokyo, Japan
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