Pharyngocele: infrequent etiology of dysphagia
Pharyngocele is a herniation of the lateral wall of the pharynx. It is uncommon and usually goes unnoticed, since it can have a variable size and not even be felt on the physical exam. In some cases it may be bilateral. Dysphagia is one of its most frequent manifestations. The favoring...
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| Autores principales: | , , , , , , , |
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| Formato: | Artículo revista |
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Universidad Nacional Córdoba. Facultad de Ciencias Médicas. Secretaria de Ciencia y Tecnología
2022
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| Acceso en línea: | https://revistas.unc.edu.ar/index.php/med/article/view/39154 |
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| Sumario: | Pharyngocele is a herniation of the lateral wall of the pharynx. It is uncommon and usually goes unnoticed, since it can have a variable size and not even be felt on the physical exam. In some cases it may be bilateral. Dysphagia is one of its most frequent manifestations. The favoring factors are the congenital or acquired weakness of the herniated areas and the increase in intrapharyngeal pressure. Age decreases the elasticity of tissues predisposing to their formation. The treatment can be conservative or surgical, depending on the clinic. The objective of this work is to expose a rare disease that manifests with dysphagia, a common symptom in adults.
Clinical case: 63-year-old male patient, APP: diabetes type II, varicose ulcers in the lower limbs and gastritis. A mild dysphagia for 3 to 4 years for solids, it was reported as not progressive. Normal physical exam. Previous complementary studies: normal esophageal-gastroduodenal transit (report, no images), video esophagus-gastroduodenoscopy with congestive antral gastropathy. Biopsy: chronic gastritis. Fibrolaringoscopy was performed observing retro-cricoid edema. In the phonoaudiological assessment it was observed that the discomfort improves with right-hand cephalic flexion. In the functional swallowing evaluation, as regards the three consistencies, it takes between 2 and 4 swallows per bite, with difficulty in the preparatory stage for solids. In contrast fibrolaringoscopy, he presented retention in the left piriformis sinus. The patient's studies and our assessment did not allow us to reach a diagnosis, we requested a video-fluoroscopy. It is performed with liquid, semi-solid and solid barite contrast. In the active phase of the pharyngeal stage, bilateral faringocele was observed. An expectant behavior was considered.
Swallowing disorders are a frequent reason for consultation in adults. Pharyngocele is a rare cause of dysphagia. In fibrolaringoscopy, the herniation orifice may not be observed. Interdisciplinary work is necessary for its assessment, as this case demonstrates.
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