Pharyngeal pouch

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Overview

Pharyngeal pouch
ICD-10 Q38.7
ICD-9 750.27
DiseasesDB 9922

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

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Overview

In gastroenterology, a pharyngeal pouch is a pathological pulsion diverticulum of the pharyngeal mucosa through Killian's dehiscence. Killian's dehiscence (also known as Killian's triangle) is a triangular area in the wall of the pharynx between the inferior constrictor muscle and the cricopharyngeus muscle. It represents a potentially weak spot where a pharyngoesophageal diverticulum (Zenker's diverticulum) is more likely.

At first, the pouch develops posteriorly but then it protrudes to one side, usually the left. It displaces the oesophagus laterally as it enlarges.

Incidence

Uncommon.

Risk factors

Male, old age.
Trumpet playing. Trumpeter Randy Sandke suffered this injury as a teenager, underwent surgery, took 10 years off the trumpet, and resumed playing.

Signs and symptoms

  • Dysphagia (first mouthful easily swallowed but further swallowing prevented, with regurgitation of pouch contents)
  • Night-time fits of coughing.
  • Repeated chest infections.
  • Palpable swelling in neck which may be heard to gurgle.

Investigations

  • Barium swallow.
  • Endoscopy should be avoided as the pouch can be easily perforated.

Management

Surgical excision of the pouch. Normal feeding delayed until complete healing of wound, which may take at least five days.

Complications

Fistula, mediastinitis, inhalation pneumonia and damage to recurrent laryngeal nerve

References

  • Papadakis, Maxine A.; Tierney, Lawrence M.; McPhee, Stephen J. Current Medical Diagnosis and Treatment 2003. McGraw-Hill/Appleton & Lange. ISBN 0071395938. 
  • Mirza S, Dutt SN, Minhas SS, Irving RM (2002). "A retrospective review of pharyngeal pouch surgery in 56 patients". Annals of the Royal College of Surgeons of England. 84 (4): 247–51. PMID 12215027. 
Cost Effectiveness of Pharyngeal pouch

| group5 = Clinical Trials Involving Pharyngeal pouch | list5 = Ongoing Trials on Pharyngeal pouch at Clinical Trials.govTrial results on Pharyngeal pouchClinical Trials on Pharyngeal pouch at Google


| group6 = Guidelines / Policies / Government Resources (FDA/CDC) Regarding Pharyngeal pouch | list6 = US National Guidelines Clearinghouse on Pharyngeal pouchNICE Guidance on Pharyngeal pouchNHS PRODIGY GuidanceFDA on Pharyngeal pouchCDC on Pharyngeal pouch


| group7 = Textbook Information on Pharyngeal pouch | list7 = Books and Textbook Information on Pharyngeal pouch


| group8 = Pharmacology Resources on Pharyngeal pouch | list8 = AND (Dose)}} Dosing of Pharyngeal pouchAND (drug interactions)}} Drug interactions with Pharyngeal pouchAND (side effects)}} Side effects of Pharyngeal pouchAND (Allergy)}} Allergic reactions to Pharyngeal pouchAND (overdose)}} Overdose information on Pharyngeal pouchAND (carcinogenicity)}} Carcinogenicity information on Pharyngeal pouchAND (pregnancy)}} Pharyngeal pouch in pregnancyAND (pharmacokinetics)}} Pharmacokinetics of Pharyngeal pouch


| group9 = Genetics, Pharmacogenomics, and Proteinomics of Pharyngeal pouch | list9 = AND (pharmacogenomics)}} Genetics of Pharyngeal pouchAND (pharmacogenomics)}} Pharmacogenomics of Pharyngeal pouchAND (proteomics)}} Proteomics of Pharyngeal pouch


| group10 = Newstories on Pharyngeal pouch | list10 = Pharyngeal pouch in the newsBe alerted to news on Pharyngeal pouchNews trends on Pharyngeal pouch</small>


| group11 = Commentary on Pharyngeal pouch | list11 = Blogs on Pharyngeal pouch

| group12 = Patient Resources on Pharyngeal pouch | list12 = Patient resources on Pharyngeal pouchDiscussion groups on Pharyngeal pouchPatient Handouts on Pharyngeal pouchDirections to Hospitals Treating Pharyngeal pouchRisk calculators and risk factors for Pharyngeal pouch


| group13 = Healthcare Provider Resources on Pharyngeal pouch | list13 = Symptoms of Pharyngeal pouchCauses & Risk Factors for Pharyngeal pouchDiagnostic studies for Pharyngeal pouchTreatment of Pharyngeal pouch

| group14 = Continuing Medical Education (CME) Programs on Pharyngeal pouch | list14 = CME Programs on Pharyngeal pouch

| group15 = International Resources on Pharyngeal pouch | list15 = Pharyngeal pouch en EspanolPharyngeal pouch en Francais

| group16 = Business Resources on Pharyngeal pouch | list16 = Pharyngeal pouch in the MarketplacePatents on Pharyngeal pouch

| group17 = Informatics Resources on Pharyngeal pouch | list17 = List of terms related to Pharyngeal pouch


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