Laparoscopic transhiatal surgery for an epiphrenic esophageal diverticulum derived from a jackhammer esophagus: a case report
Abstract Background An esophageal diverticulum is rare and is frequently associated with esophageal motility disorders. Jackhammer esophagus is also rare, is characterized by esophageal hypercontraction, and comprises 4.1% of esophageal motility disorders. Here, we report a case of a patient success...
Saved in:
| Main Authors: | , , , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Japan Surgical Society
2020-06-01
|
| Series: | Surgical Case Reports |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s40792-020-00900-2 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1849709611624431616 |
|---|---|
| author | Atsuro Fujinaga Tomotaka Shibata Tsuyoshi Etoh Kazuhiro Tada Kosuke Suzuki Kohei Nishiki Katsuhiro Ogawa Yohei Kono Takahiro Hiratsuka Tomonori Akagi Yoshitake Ueda Manabu Toujigamori Hidefumi Shiroshita Norio Shiraishi Masafumi Inomata |
| author_facet | Atsuro Fujinaga Tomotaka Shibata Tsuyoshi Etoh Kazuhiro Tada Kosuke Suzuki Kohei Nishiki Katsuhiro Ogawa Yohei Kono Takahiro Hiratsuka Tomonori Akagi Yoshitake Ueda Manabu Toujigamori Hidefumi Shiroshita Norio Shiraishi Masafumi Inomata |
| author_sort | Atsuro Fujinaga |
| collection | DOAJ |
| description | Abstract Background An esophageal diverticulum is rare and is frequently associated with esophageal motility disorders. Jackhammer esophagus is also rare, is characterized by esophageal hypercontraction, and comprises 4.1% of esophageal motility disorders. Here, we report a case of a patient successfully treated by laparoscopic transhiatal surgery for an epiphrenic esophageal diverticulum derived from a jackhammer esophagus diagnosed with high-resolution manometry (HRM). Case presentation The patient was a 78-year-old man who presented to the hospital with dysphagia. A diverticulum was detected in the lower part of his esophagus by upper gastrointestinal endoscopy. HRM was performed to investigate esophageal motility disorders. His integrated relaxation pressure was normal at 25.9 (< 26) mmHg, but his distal contractile integral (DCI) was very high at 21,464 (1500–13,000) mmHg s cm. Esophageal peristalsis was preserved. Therefore, the patient was diagnosed as having an epiphrenic esophageal diverticulum derived from a jackhammer esophagus for which laparoscopic transhiatal diverticulectomy and Heller-Dor procedure were performed. The postoperative course was uneventful. His symptoms improved, and the level of DCI also returned to a normal level of 3867 mmHg s cm at 2 months after the operation. Conclusion Laparoscopic transhiatal diverticulectomy and esophagomyotomy can be useful procedures for an epiphrenic esophageal diverticulum derived from a jackhammer esophagus due to their lower invasiveness. |
| format | Article |
| id | doaj-art-210d8efa74f041ed8ee73390787f47a2 |
| institution | DOAJ |
| issn | 2198-7793 |
| language | English |
| publishDate | 2020-06-01 |
| publisher | Japan Surgical Society |
| record_format | Article |
| series | Surgical Case Reports |
| spelling | doaj-art-210d8efa74f041ed8ee73390787f47a22025-08-20T03:15:13ZengJapan Surgical SocietySurgical Case Reports2198-77932020-06-01611510.1186/s40792-020-00900-2Laparoscopic transhiatal surgery for an epiphrenic esophageal diverticulum derived from a jackhammer esophagus: a case reportAtsuro Fujinaga0Tomotaka Shibata1Tsuyoshi Etoh2Kazuhiro Tada3Kosuke Suzuki4Kohei Nishiki5Katsuhiro Ogawa6Yohei Kono7Takahiro Hiratsuka8Tomonori Akagi9Yoshitake Ueda10Manabu Toujigamori11Hidefumi Shiroshita12Norio Shiraishi13Masafumi Inomata14Department of Gastroenterological and Pediatric Surgery, Oita University Faculty of MedicineDepartment of Gastroenterological and Pediatric Surgery, Oita University Faculty of MedicineDepartment of Gastroenterological and Pediatric Surgery, Oita University Faculty of MedicineDepartment of Gastroenterological and Pediatric Surgery, Oita University Faculty of MedicineDepartment of Gastroenterological and Pediatric Surgery, Oita University Faculty of MedicineDepartment of Gastroenterological Surgery, Oita Nakamura HospitalDepartment of Gastroenterological and Pediatric Surgery, Oita University Faculty of MedicineDepartment of Gastroenterological and Pediatric Surgery, Oita University Faculty of MedicineDepartment of Gastroenterological and Pediatric Surgery, Oita University Faculty of MedicineDepartment of Gastroenterological and Pediatric Surgery, Oita University Faculty of MedicineDepartment of Comprehensive Surgery for Community Medicine, Oita University Faculty of MedicineDepartment of Gastroenterological and Pediatric Surgery, Oita University Faculty of MedicineDepartment of Gastroenterological and Pediatric Surgery, Oita University Faculty of MedicineDepartment of Comprehensive Surgery for Community Medicine, Oita University Faculty of MedicineDepartment of Gastroenterological and Pediatric Surgery, Oita University Faculty of MedicineAbstract Background An esophageal diverticulum is rare and is frequently associated with esophageal motility disorders. Jackhammer esophagus is also rare, is characterized by esophageal hypercontraction, and comprises 4.1% of esophageal motility disorders. Here, we report a case of a patient successfully treated by laparoscopic transhiatal surgery for an epiphrenic esophageal diverticulum derived from a jackhammer esophagus diagnosed with high-resolution manometry (HRM). Case presentation The patient was a 78-year-old man who presented to the hospital with dysphagia. A diverticulum was detected in the lower part of his esophagus by upper gastrointestinal endoscopy. HRM was performed to investigate esophageal motility disorders. His integrated relaxation pressure was normal at 25.9 (< 26) mmHg, but his distal contractile integral (DCI) was very high at 21,464 (1500–13,000) mmHg s cm. Esophageal peristalsis was preserved. Therefore, the patient was diagnosed as having an epiphrenic esophageal diverticulum derived from a jackhammer esophagus for which laparoscopic transhiatal diverticulectomy and Heller-Dor procedure were performed. The postoperative course was uneventful. His symptoms improved, and the level of DCI also returned to a normal level of 3867 mmHg s cm at 2 months after the operation. Conclusion Laparoscopic transhiatal diverticulectomy and esophagomyotomy can be useful procedures for an epiphrenic esophageal diverticulum derived from a jackhammer esophagus due to their lower invasiveness.http://link.springer.com/article/10.1186/s40792-020-00900-2Jackhammer esophagusEpiphrenic esophageal diverticulumMyotomy |
| spellingShingle | Atsuro Fujinaga Tomotaka Shibata Tsuyoshi Etoh Kazuhiro Tada Kosuke Suzuki Kohei Nishiki Katsuhiro Ogawa Yohei Kono Takahiro Hiratsuka Tomonori Akagi Yoshitake Ueda Manabu Toujigamori Hidefumi Shiroshita Norio Shiraishi Masafumi Inomata Laparoscopic transhiatal surgery for an epiphrenic esophageal diverticulum derived from a jackhammer esophagus: a case report Surgical Case Reports Jackhammer esophagus Epiphrenic esophageal diverticulum Myotomy |
| title | Laparoscopic transhiatal surgery for an epiphrenic esophageal diverticulum derived from a jackhammer esophagus: a case report |
| title_full | Laparoscopic transhiatal surgery for an epiphrenic esophageal diverticulum derived from a jackhammer esophagus: a case report |
| title_fullStr | Laparoscopic transhiatal surgery for an epiphrenic esophageal diverticulum derived from a jackhammer esophagus: a case report |
| title_full_unstemmed | Laparoscopic transhiatal surgery for an epiphrenic esophageal diverticulum derived from a jackhammer esophagus: a case report |
| title_short | Laparoscopic transhiatal surgery for an epiphrenic esophageal diverticulum derived from a jackhammer esophagus: a case report |
| title_sort | laparoscopic transhiatal surgery for an epiphrenic esophageal diverticulum derived from a jackhammer esophagus a case report |
| topic | Jackhammer esophagus Epiphrenic esophageal diverticulum Myotomy |
| url | http://link.springer.com/article/10.1186/s40792-020-00900-2 |
| work_keys_str_mv | AT atsurofujinaga laparoscopictranshiatalsurgeryforanepiphrenicesophagealdiverticulumderivedfromajackhammeresophagusacasereport AT tomotakashibata laparoscopictranshiatalsurgeryforanepiphrenicesophagealdiverticulumderivedfromajackhammeresophagusacasereport AT tsuyoshietoh laparoscopictranshiatalsurgeryforanepiphrenicesophagealdiverticulumderivedfromajackhammeresophagusacasereport AT kazuhirotada laparoscopictranshiatalsurgeryforanepiphrenicesophagealdiverticulumderivedfromajackhammeresophagusacasereport AT kosukesuzuki laparoscopictranshiatalsurgeryforanepiphrenicesophagealdiverticulumderivedfromajackhammeresophagusacasereport AT koheinishiki laparoscopictranshiatalsurgeryforanepiphrenicesophagealdiverticulumderivedfromajackhammeresophagusacasereport AT katsuhiroogawa laparoscopictranshiatalsurgeryforanepiphrenicesophagealdiverticulumderivedfromajackhammeresophagusacasereport AT yoheikono laparoscopictranshiatalsurgeryforanepiphrenicesophagealdiverticulumderivedfromajackhammeresophagusacasereport AT takahirohiratsuka laparoscopictranshiatalsurgeryforanepiphrenicesophagealdiverticulumderivedfromajackhammeresophagusacasereport AT tomonoriakagi laparoscopictranshiatalsurgeryforanepiphrenicesophagealdiverticulumderivedfromajackhammeresophagusacasereport AT yoshitakeueda laparoscopictranshiatalsurgeryforanepiphrenicesophagealdiverticulumderivedfromajackhammeresophagusacasereport AT manabutoujigamori laparoscopictranshiatalsurgeryforanepiphrenicesophagealdiverticulumderivedfromajackhammeresophagusacasereport AT hidefumishiroshita laparoscopictranshiatalsurgeryforanepiphrenicesophagealdiverticulumderivedfromajackhammeresophagusacasereport AT norioshiraishi laparoscopictranshiatalsurgeryforanepiphrenicesophagealdiverticulumderivedfromajackhammeresophagusacasereport AT masafumiinomata laparoscopictranshiatalsurgeryforanepiphrenicesophagealdiverticulumderivedfromajackhammeresophagusacasereport |