A male aged 60 years has foul breath; He regurgitates food that is eaten 3 days ago. A gurgling sound is often heard on swallowing : Likely diagnosis is:
Answer is A (Zenker's diveiculum) Regurgitation ()flood eaten 3 days ago hints to the possibility of another sac / diveiculum which stores food. Age of the patient and gurgling sound suppo the diagnosis of Zenkers diveiculum. Zenker's diveiculum What it is : It is a pulsion diveiculume, where pharyngeal mucosae herniates through the Killihan's dehiscence (a weak area between two pas of Inferior Constrictore). Age of presentation This condition is usually seen after 60 years of age (elderly)Q Symptomatology / presentation * Dysphagiadeg : As mouth of the sac is wider than the opening of esophagus, food preferentially enter the sac. When the pouch gets filled with food, it presses on the esophagus & produces DysphagiaQ * Gurgling Sound is produced during swallowing. * Halitosis or foul smell is frequently associated * Cough & Aspiration pneumoniaQ : food eaten over the last few days may regurgitate as it collects in the pouch causing cough and aspiration pneumonia. * MalnutritionQ : Patient is often malnourished due to dysphagia.
Zenkers diveiculum
Meckels diveiculum
Scleroderma
Achalasia cardia