A 60-year-old woman presents with a lump in the middle of her neck. She is also troubled by regurgitation of her food. On examination, the midline lump gurgles on palpation.
The diagnosis, in this case, is a pharyngeal pouch.
A pharyngeal pouch is a posteromedial pulsion diverticulum through Killian’s dehiscence. It occurs when there is a herniation between the cricopharyngeus muscle and the thyropharyngeus muscle. These two muscles form part of the inferior constrictor of the pharynx.
Presenting symptoms include:
- Chronic cough
- Weight loss
There are often no clinical signs, but if there is a palpable lump, it may gurgle on palpation.
Surgical intervention may be minimally invasive, involving endoscopic stapling or more invasive treatment for larger pouches.
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