• Journal of Chest Surgery
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• v.43 no.3
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• pp.324-327
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• 2010

Killian-Jamieson diverticulum is a rare disease that is seen at the cervical esophagus. It has quite a different pathogenesis and anatomical location compared with that of Zenker's diverticulum. The pathophysiology and strategy for treating Killian-Jamieson diverticulum are not fully understood. We performed surgery using one incision for treating a case of Killian-Jamieson diverticulum and we review the medical literature that's related to this unusual diverticulum.

• Journal of Chest Surgery
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• v.15 no.4
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• pp.447-450
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• 1982

A 45 year old male officer was admitted due to upper substernal pain for 1 month, which was aggravated by swallowing. On past and family history, there was no specific history except heavy drinking. Simple chest x-ray revealed no specific abnormal findings. Preoperative esophagofiberscopy and Barium study showed midesophageal diverticulum, pulsion type, at about 2 cm below the left main bronchus. The opening of the diverticulum was located at the left posterolateral aspect of esophagus. Midesophageal false diverticulum, measuring 2 x 2 x 1 .S cm in size, was noted at about 5 cm under the aortic arch protruding through a slit-like muscular defect. After inversion of diverticular sac, interrupted sutures with 3-0 silks were done on muscular defect site, and mediastinal pleura was reinforced on the lesion with interrupted sutures. On 4th postoperative day, esophagography revealed no diverticulum or stenosis. Also esophagofiberscopy showed smooth mucosal tag without disturbance of passage. On 14th postoperative day, the patient was discharged uneventfully, and follow-up for 3 months after discharge revealed nothing abnormal symptoms. The authors report one case of midesophageal, pulsion type, false diverticulum.

• Advances in pediatric surgery
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• v.11 no.2
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• pp.175-179
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• 2005

An 11-year-old girl with a history of two previous attacks of acute pancreatitis was admitted to another hospital. Her epigastrium was tender, and serum amylase was 657 IU/L and lipase 3131 IU/L. Abdominal computed tomography scan suggested necrosis of 30% of the pancreas. Retrograde endoscopic cholangiopancreatography showed a diverticulum covered by normal duodenal mucosa at the second portion of the duodenum, which was separated from the adjacent duodenal lumen by a radiolucent band at UGI series. The apex of the diverticulum was incised endoscopically using a needle knife papillotome. A follow-up endoscopy on the next day noticed bleeding from the incised edge of the diverticulum. Endoscopic hemostasis with hemoclipping and injection of hypertonic saline-epinephrine solution was not successful. The patient was transferred to Kyungpook National University Hospital, and open duodenotomy and excision of the diverticulum were performed. She has recovered well and remains asymptoatic.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.8 no.2
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• pp.222-225
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• 2005

Meckel's diverticulum is generally acknowledged to be the most prevalent congenital anomaly of the gastrointestinal tract. The preoperative diagnosis of Meckel's diverticulum is difficult, especially in neonates, because of the lesions ability to masquerade as one of a variety of much more common abdominal pathologies. Recently we experienced a case of perforated Meckel's diverticulum with mild inflammatory reaction, intestinal adhesion, and small bowel obstruction in a previous healthy 9-day-old neonate. The spontaneous perforation of Meckel's diverticulum in neonate is very rare but serious entity. The course was rapid and progressed to sepsis. So despite its varied presentation, Meckel's diverticulum should be kept in mind as a cause of acute abdomen in neonates.

• Advances in pediatric surgery
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• v.13 no.2
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• pp.127-134
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• 2007

Meckel's diverticulum is the most common congenital anomaly of gastrointestinal tract in children. The incidence of complicated Meckel's diverticulum is about 4 %. The major complications of Meckel's diverticulum are bleeding, intussusception, obstruction and perforation. The aim of this study was to investigate the clinical manifestations and the role of laparoscopic surgery in complicated Meckel's diverticulum in children. We retrospectively reviewed the medical records of 19 patients with complicated Meckel's diverticulum who underwent operation at Asan Medical Center between Jan. 1990 and Apr. 2007. Male to female ratio was 11:8, and median age was 1 year (1 day-13 years). The most frequent symptom was hematochezia (68%), followed by irritability or abdominal pain (16%), vomiting (11%), and abdominal distension (5%). Two operative procedures were performed; small bowel resection with anastomosis (68%) and diverticulectomy (32%). The operation proven complications of the Meckel's diverticulum were bleeding (68%), intussusception (16%), perforation (11%) and obstruction (5%). Ectopic tissues found by postoperative pathologic examination were gastric (84%) and pancreatic (11%). Hospital stay after laparoscopic operation for bleeding Meckel's was 5 days (median) and average first postoperative feeding was 1.5 days. On the contrary, hospital stay for open surgery was 7 days and first feed was 3 days. In summary, the most common compliation of Meckel's diverticulum in children was bleeding and ectopic gastric tissues were present in 84%. Laparoscopic procedure seemed to be useful for diagnosis as well as for definitive treatment.

• Advances in pediatric surgery
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• v.4 no.1
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• pp.27-33
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• 1998

Of 72 patients with vitelline duct and vessel remnants, 45 (62.5 %) had symptomatic lesions. The mean age of the patients was 27.9 months. Males predominated (4.6 : 1). There were 22 cases of Meckel's diverticulum, 6 of Meckel's diverticulum attatched to the umbilicus with a fibrous band, 6 cases of patent vitelline duct, 5 cases of vitelline artery remnants as a fibrous band and 2 cases each of umbilical sinus and polyp, and vitelline cyst. Twenty-three patients (51 %) presented with intestinal obstruction, 6(13 %) with rectal bleeding, 4(9 %) with perforated Meckel's diverticulum, 5 with intestinal juice drainage through umbilicus, 5 with umbilical lesions, 1 with abdominal mass, and 1 with sepsis. Intestinal obstruction due to fibrous band developed during infancy(average age; 4.6 months). Seventeen asymptomatic Meckel's diverticulum, 8 obliterated vitelline artery remnants and 1 vitelline vein remnant as fibrous band, and 1 vitelline cyst were found incidentally at laparotomy. About 82 % of the complicated Meckel's diverticulum presented in infants and children less than 4 years of age.

• Korean Journal of Bronchoesophagology
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• v.15 no.2
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• pp.87-91
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• 2009

Esophageal diverticulum is a rare entity, the true incidence of which is unknown, mainly because there are usually no clinical symptoms. Most esophageal diverticulum are found incidentally during an endoscopic or radiologic examination. Their classification is based on anatomical location; namely, upper third(Zenker or pharyngoesophageal), middle third(thoracic), or lower third(epiphrenic). Here we report a 52-years-old female presenting with dysphagia and regurgitation. Esophagogram showed esophageal diveticulum at lower cervical esophagus. Its positional aspect, it is different from Zenker's diveticulum. Treatment is surgical via an endoscopic or external approach. In view of the patient's age and anatomical location, various surgical approaches were considered as a therapeutic option for the management. This paper presents our experience in the management of esophageal diverticulum which was unusual location and stapled open resection without sternotomy.

• The Korean Journal of Nuclear Medicine
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• v.32 no.2
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• pp.172-177
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• 1998

We report a case of gastro-colic fistula caused by ectopic gastric mucosa developed at transverse colon. Fistula was detected by colonofiberscopy. And fistulous tract was proved by barium enema. Meckel's diverticulum scan finding was similar to that of GI bleeding; e.g. injected radioactivity was secreted into the lumen and moved along the lumen. There was no bleeding. And there was no diverticulum in the colon. Absence of diverticular pouch may explain this unusual GI bleeding-like scan finding rather than focal collection of radioactivity, which is typical of ectopic gastric mucosa found in the Meckel's diverticulum. Ectopic gastric mucosa was confirmed by colonofiberscopic biopsy. We suggest GI bleeding-like pictures should be included in differential diagnosis of $^{99m}TcO_4$ (ectopic gastric mucosa or Meckel's diverticulum) scan.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.8 no.1
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• pp.56-59
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• 2005

Intussusception is the most common cause of intestinal obstruction in early childhood and characterized by periodic colicky abdominal pain or irritability, vomiting, current jelly stool, and sausage-like abdominal mass. Meckel's diverticulum is common intestinal anomaly presenting with painless rectal bleeding during first 2 year of age. It is recognized as a common leading point of intussusception in childhood. Hematemesis is the rare clinical manifestation of both intussusception and Meckel's diverticulum. A 7-year-old girl presented with hematemesis was diagnosed as having intussusception by abdominal ultrasonography. Meckel's diverticulum was the leading point of intussusception in this case.

• Journal of Chest Surgery
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• v.24 no.5
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• pp.510-514
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• 1991

A fistulous communication between an esophageal traction diverticulum and the tracheo-bronchial tree appears to be of rare occurrence. This report reviews the feature of congenital esophagobronchial fistula associated with esophageal traction diverticulum. This 38-year-old male patient suffered from coughing, hemoptysis, fever and chest pain. This patient was taken a diverticulectomy and lobectomy of right lower lobe. Post-operation course was uneventful.