Pharyngeal pouch

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This article is about the condition. For the embryological structure, see Branchial pouch.

**Pharyngeal pouch**
*Classification & external resources*
ICD-10	Q38.7
ICD-9	750.27

In gastroenterology, a pharyngeal pouch is a pathological 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.

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

1 Incidence
2 Risk factors
3 Signs and symptoms
4 Investigations
5 Management
6 Complications
7 References

[edit] Incidence

Uncommon.

[edit] Risk factors

Male, old age.

[edit] Signs and symptoms

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.

[edit] Investigations

Barium swallow.
Endoscopy should be avoided as the pouch can be easily perforated.

[edit] Management

Surgical excision of the pouch. Normal feeding delayed until complete healing of wound, which may take at least five days.

[edit] Complications

Fistula, mediastinitis, inhalation pneumonia and damage to recurrent laryngeal nerve

[edit] References

Current Medical Diagnosis & Treatment 2003. Eds. Tierney LM et al. Lange Medical Books.
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]

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