NationMaster - Encyclopedia: Pharyngeal pouch

A pharyngeal pouch is a pulsion diverticulum of the pharyngeal mucosa through Killian's dehiscence. Killian's dehiscence (also known as Killian's triangle) is a triangular area in the wall of the pharynx between the inferior constrictor muscle and the cricopharyngeus muscle. It represents a potentially weak spot where a pharyngoesophageal diverticulum (Zenker's diverticulum) is more likely. Jump to: navigation, search The following codes are used with International Statistical Classification of Diseases and Related Health Problems. ... The following is a list of codes for International Statistical Classification of Diseases and Related Health Problems. ... Diverticula are outpouchings of the intestinal wall. ...

At first, the pouch develops posteriorly but then it protrudes to one side, usually the left. It displaces the oesophagus laterally as it enlarges.

Incidence Uncommon

Risk Factors Male, old age.

Symptoms & Signs Dysphagia. (First mouthful easily swallowed but further swallowing prevented, with regurgitation of pouch contents) Night-time fits of coughing. Repeated chest infections. Palpable swelling in neck which may be heard to gurgle.

Investigations Barium swallow. Endoscopy should be avoided: pouch can be easily perforated.

Management Surgical Excision of the pouch. Normal feeding delayed until complete healing of wound, which may take at least five days. Complications Fistula, mediastinitis, inhalation pneumonia and damage to recurrent laryngeal nerve

References Used

 1. Current Medical Diagnosis & Treatment 2003. Eds. Tierney LM et al. Lange Medical Books. 2. Mirza S, Dutt SN, Minhas SS, et al; A retrospective review of pharyngeal pouch surgery in 56 patients.;Ann R Coll Surg Engl 2002 Jul;84(4):247-51.[abstract]

Results from FactBites:

Chronic cough (485 words)
	A pharyngeal pouch or Zenker's diverticulum is a pulsion diverticulum that arises between the cricopharyngeus and thyropharyngeus muscles of the inferior pharyngeal constrictor.
	As pharyngeal pouches usually arise in the elderly, their management is often determined by the general fitness of the patient and the presence of any co-morbid conditions.
	Surgery for a pharyngeal pouch, particularly if an external approach is used, is often associated with a significant risk of complications and peri-operative mortality rates of 2% have been reported.

I. Embryology. 12. The Branchial Region. Gray, Henry. 1918. Anatomy of the Human Body. (2206 words)
	The first pharyngeal pouch is prolonged dorsally to form the auditory tube and the tympanic cavity; the closing membrane between the mandibular and hyoid arches is invaded by mesoderm, and forms the tympanic membrane.
	From the third pharyngeal pouch the thymus arises as an entodermal diverticulum on either side, and from the fourth pouches small diverticula project and become incorporated with the thymus, but in man these diverticula probably never form true thymus tissue.
	From the fifth pouches the ultimobranchial bodies originate and are enveloped by the lateral prolongations of the median thyroid rudiment; they do not, however, form true thyroid tissue, nor are any traces of them found in the human adult.

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