Esophagus Killian-Jamieson Diverticulum-Case Report and Review of the Literature

食道Killian-Jamieson憩室－病例報告及文獻回顧

黃詩芸(Shih-Yun Huang) ； 王仲祺(Chen-Chi Wang)

《台灣耳鼻喉頭頸外科雜誌》 56卷4期 (2021/12) Pp. 253-258

https://doi.org/10.6286/jtohns.202112_56(4).253

摘要

Esophagus Killian-Jamieson diverticulum (KJD) is a rare pharyngoesophageal diverticulum, originating inferior to the cricopharyngeus muscle and residing anterolaterally to the esophagus. A 54 y/o woman complained of experiencing dysphagia with a lumpy sensation at the level of the thyroid gland, as well as regurgitation for several months, particularly after solid food intake. A flexible laryngoscopy revealed no lesions at the upper aerodigestive tract. Esophageal diverticulum was suspected, and a cervical CT revealed a focal lesion with air posterior to the left lobe of the thyroid gland. An esophagography revealed a contrast-filled outpouching over the left anterolateral aspect of the esophageal wall at the C6-C7 level, which resulted in a diagnosis of KJD. Because KJD was close to the recurrent laryngeal nerve (RLN), the patient received a transcervical diverticulum resection with intra-operative neuro-monitoring (IONM). The patient's symptoms subsequently subsided, and there was no diverticulum recurrence after 12 months of follow-up. Although KJD is rare and mimics a thyroid tumor, the diagnosis could be confirmed through an esophagography. We recommended that the diverticulum should be removed transcervically under the guidance of IONM to avoid injuring the recurrent laryngeal nerve.

關鍵字

Killian-Jamieson diverticulum ； pharyngoesophageal diverticulum

並列摘要

食道Killian-Jamieson憩室為罕見之咽食道憩室，源自環咽肌之下、食道縱走肌外側的Killian-Jamieson區域。本案例為1名54歲女性，於2020年3月間至本院求診，主訴有甲狀腺部位的腫塊、喉部異物感、吞嚥困難、進食後嘔吐現象好幾個月。使用鼻咽內視鏡未發現明顯病灶，頸部電腦斷層顯示病灶可能為緊貼甲狀腺、位於氣管食道溝的食道憩室，我們用食道攝影及食道鏡檢證實此診斷。因憩室緊貼返喉神經，手術採經頸部切除並使用返喉神經監測器。追蹤至今病人症狀痊癒且無併發症，也無滲漏復發跡象。此病臨床症狀複雜、易被誤診且治療可能產生併發症故特別提出報告討論。

並列關鍵字

Killian-Jamieson diverticulum ； pharyngoesophageal diverticulum（Killian-Jamieson憩室 ； 咽食道憩室）