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04-21-2008, 11:23 AM
mAetiology:
Muscular incoordination between transverse and oblique fibers of cricopharyngeus muscle herniation of mucosa through "Killian dehiscence"
mClinical Picture:
Old male with regurgitation & dysphagia. In late cases cyst may be felt in Lt. side of the neck which increase in size after eating.
mTreatment:
Myotomy. Diverticulopexy then diverticulectomy.
Diverticulopexy alone may cure the conditions.
2) Diffuse spasm Multiple areas of spasm "corkscrew oesophagus" in barium swallow.It give mild symptoms & need only dilatation.
3) Plummer-Vinson Syndrome which consists of :
A) Dysphagia: early due to spasm in the upper end of oesophagus associated with web formation & late due to fibrosis and stricture. Mucosa shows areas of hyperkeratosis and desquamation & this lesion is precancerous.
B) Associated signs: Smooth tongue. " devoid of papillae", Spoon shaped, nails, Splenic enlargement, Achlorohydria and Anaemia.
4) Sclerodermia: It is smooth muscle atrophy with collagen replacement forming rigid part with ineffective peristalsis.
It occurs as a part of systemic syndrome.
5) Chagas disease: it is a parasitic disease caused by trypanosoma cruzi and is endemic in Brazil and South America; causes degeneration of the myenteric plexus of Auerbach, and is identical to achalasia and is managed in the same way. Dilatation is the preferred method of treatment, due to the poor general condition.

SOURCE: DR. AYMAN SALEM'S BOOK
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