Anesthetic Management of Bilateral Zenker's Diverticulums

A 71-year-old woman diagnosed with bilateral Zenker's diverticulum (ZD) was scheduled for diverticulectomy. ZD is a sac-like deformation in the posterior wall of the lower pharynx between the thyropharyngeal and cricopharyngeal muscles. Regurgitation at the induction of general anesthesia is on...

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Bibliographic Details
Published inTHE JOURNAL OF JAPAN SOCIETY FOR CLINICAL ANESTHESIA Vol. 32; no. 5; pp. 786 - 790
Main Authors SUZUKI, Tomofumi, TOKUDA, Rui, HANASHIRO, Ako, KOBASHIGAWA, Teruyo, KAMIKAWA, Michie
Format Journal Article
LanguageJapanese
Published THE JAPAN SOCIETY FOR CLINICAL ANESTHESIA 2012
Subjects
Pharyngoesophageal diverticulum
Regurgitation
Zenker's diverticulum
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Summary:A 71-year-old woman diagnosed with bilateral Zenker's diverticulum (ZD) was scheduled for diverticulectomy. ZD is a sac-like deformation in the posterior wall of the lower pharynx between the thyropharyngeal and cricopharyngeal muscles. Regurgitation at the induction of general anesthesia is one of the major concerns for anesthesiologists. According to previous reports, several treatments are recommended, such as aspiration of the diverticulum contents in pre-induction of anesthesia and rapid sequence induction in the heads-up position. Liquid meals for two days before the operation might be effective in this case. Also, anesthesiologists have to take extra precautions against hoarseness, and airway edema after extubation. It might be useful to observe diverticulum content directly by transnasal fiberoptic endoscopy before the induction of anesthesia. We were able to perform safe anesthetic management of the patient with ZD, which is a rare disease in Japan.
ISSN:0285-4945
1349-9149
DOI:10.2199/jjsca.32.786