Esophageal diverticulum: A complication of histoplasmosis in children

Steiner, Steven J.; Cox, Elaine G.; Gupta, Sandeep K.; Kleiman, Martin B.; Fitzgerald, Joseph F.

doi:10.1016/j.jpeds.2004.10.020

Cited by 14 publications

(3 citation statements)

References 8 publications

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“…The primary pulsion diverticulum commonly occurs at the proximal and distal ends of the esophagus and includes Zenker diverticulum and epiphrenic diverticulum. In contrast, traction diverticulum, including thoracic ED, commonly occurs in the middle of the esophagus ( 2 , 7 , 8 ). In all four patients in our series, ED was considered thoracic ED; however, the pathogenesis of ED after EA/TEF surgery is different from that of the primary ED.…”

Section: Discussionmentioning

confidence: 99%

Thoracoscopy for Esophageal Diverticula After Esophageal Atresia With Tracheo-Esophageal Fistula

et al. 2021

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Background: Esophageal diverticulum (ED) is an extremely rare complication of congenital esophageal atresia (EA) with or without tracheoesophageal fistula (TEF) surgery. We aimed to investigate feasible methods for the treatment of this rare complication.Methods: We retrospectively reviewed all patients with EA/TEF at Beijing Children's Hospital from January 2015 to September 2019. The clinicopathological features of patients with ED after EA/TEF surgery were recorded. Follow-up was routinely performed after surgery until December 2020.Results: Among 198 patients with EA/TEF, ED only occurred in four patients (2.02%; one male, three female). The four patients had varying complications after the initial operation, including anastomotic leakage (3/4), esophageal stenosis (3/4), and recurrence of TEF (1/4). The main clinical symptoms of ED included recurrent pneumonia (4/4), coughing (4/4), and dysphagia (3/4). All ED cases occurred near the esophageal anastomosis. Patients' age at the time of diverticulum repair was 6.6–16.8 months. All patients underwent thoracoscopic esophageal diverticulectomy (operation time: 1.5–3.5 h). Anastomotic leakage occurred in one patient and spontaneously healed after 2 weeks. The other three patients had no peri-operative complications. All patients were routinely followed up after surgery for 14–36 months. During the follow-up period, all patients could eat orally, had good growth and weight gain, and showed no ED recurrence or anastomotic leakage on esophagogram.Conclusions: ED is a rare complication after EA/TEF surgery and is a clear indication for diverticulectomy. During the midterm follow-up, thoracoscopic esophageal diverticulectomy was safe and effective for ED after EA/TEF surgery.

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Section: Discussionmentioning

confidence: 99%

Thoracoscopy for Esophageal Diverticula After Esophageal Atresia With Tracheo-Esophageal Fistula

et al. 2021

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“…These were commonly associated with mediastinal inflammation and scarring due to tuberculosis and histoplasmosis. 5,6 Currently, most of the mid esophageal diverticula are of the pulsion variety lacking a muscular wall and associated with an inherent motility disorder in 80 to 100% of cases. They may also be associated with fixed mechanical obstruction or rarely secondary to alkali ingestion.…”

Section: Discussionmentioning

confidence: 99%

Minimally invasive approach to a symptomatic giant mid esophageal diverticulum

et al. 2017

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Mid esophageal diverticula are a rare entity and are most commonly of pulsion variety. Though rarely symptomatic, they can result in dangerous complications like aspiration, bleeding, fistulisation and malignancy especially when they are large. They have been traditionally approached by open surgery. With the advent of minimally invasive approaches, thoracoscopic resections have been increasingly performed offering several advantages. We have described a case report of a symptomatic giant mid esophageal diverticulum successfully managed by minimally invasive approach.

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“…Histoplasma is another dimorphic fungus that generally causes a subclinical or self-limiting respiratory infection. Children have been reported to develop esophageal diverticulum caused by histoplasmosis with symptoms of dysphagia (48).…”

Section: Other Causes Of Fungal Esophagitismentioning

confidence: 99%

Infectious Esophagitis in Children

O’Donnell

Krishnan

2022

J. pediatr. gastroenterol. nutr.

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Infectious esophagitis is the third most common cause of esophagitis after gastroesophageal reflux disease and eosinophilic esophagitis (EoE) and should always be considered in the differential of patients with dysphagia and odynophagia. The most common organisms causing disease are candida, Herpes simplex virus (HSV) and cytomegalovirus (CMV). It is well recognized that an impaired local or systemic immune system is a risk factor for disease; however, esophageal dysmotility and disruptions in esophageal homeostasis and the esophageal milieu are likely to represent additional risk factors in disease pathogenesis.

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Esophageal diverticulum: A complication of histoplasmosis in children

Cited by 14 publications

References 8 publications

Thoracoscopy for Esophageal Diverticula After Esophageal Atresia With Tracheo-Esophageal Fistula

Thoracoscopy for Esophageal Diverticula After Esophageal Atresia With Tracheo-Esophageal Fistula

Minimally invasive approach to a symptomatic giant mid esophageal diverticulum

Infectious Esophagitis in Children

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