%0 Journal Article
%T Divert¨ªculo epifr¨¦nico Epinephrine diverticulum
%A Moraima Emilia Vall¨¦s Gamboa
%A Orlando Rafael Exp¨®sito Reyes
%A Carlos Gaetano Ferreiro
%A Yaima Susana Rey Vall¨¦s
%J Revista Cubana de Cirug¨ªa
%D 2011
%I Editorial Ciencias M¨¦dicas
%X El divert¨ªculo epifr¨¦nico provocado por el aumento de la presi¨®n intraesof¨¢gica a causa de alteraciones motoras subyacentes es raro; representa cerca del 10 % de todos los divert¨ªculos esof¨¢gicos. Se presenta el caso de una paciente de 65 a os de edad, que ingres¨® en el Servicio de Cirug¨ªa General con ictericia obstructiva por pancreatitis cr¨®nica. Se le realiz¨® una triple derivaci¨®n de Catell y durante la evoluci¨®n posoperatoria comenz¨® a presentar v¨®mitos que conten¨ªan alimentos sin digerir, f¨¦tidos, ingeridos con horas o d¨ªas de antelaci¨®n. Se le realiz¨® una radiograf¨ªa baritada de es¨®fago, est¨®mago y duodeno, con buen pase de contraste al duodeno, y se observ¨® la presencia de un divert¨ªculo epifr¨¦nico de gran tama o, responsable de los s¨ªntomas. Fue intervenida quir¨²rgicamente utilizando como v¨ªa de acceso una incisi¨®n media previa y v¨ªa transhiatal. Se practic¨® una vagotom¨ªa, diverticulectom¨ªa, miotom¨ªa esof¨¢gica extendida, procedimiento antirreflujo y yeyunostom¨ªa temporal para la alimentaci¨®n precoz. La evoluci¨®n fue favorable y la paciente est¨¢ hoy asintom¨¢tica. The epinephrine diverticulum due to the increase of intraesophageal pressure by underlying motor alterations is a rare entity; it accounts for around the 10% of all esophageal diverticula. This is the case of a female patient aged 65 admitted in the General Surgery Service presenting with obstructive jaundice by chronic pancreatitis. A triple Catell's bypass was carried out and during the postoperative course had vomiting containing non-digested fetid foods, ingested many hours or days ago. Barium radiography of esophagus, stomach and duodenum was obtained with a good contrast passage, verifying the presence of a very large epinephrine diverticulum causing the symptoms. She was operated on using as approach route a previous middle incision and trans-hiatal route. A vagotomy, diverticulectomy, extended esophageal myotomy, anti-reflux procedure and temporary jejunostomy for the early feeding. Course was favorable and patient remains asymptomatic.
%K Divert¨ªculo epifr¨¦nico
%K trastorno motor esof¨¢gico
%K Epinephrine diverticulum
%K esophageal motor disorder
%U http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S0034-74932011000200011