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Surgery G.I.T 89306bef

A 45-year-old man presented with regurgitated food paicles eaten several days earlier. He has foul smelling breath and occasional dysphagia for solid food. What is the probable diagnosis

A
Gastric outlet obstruction
B
Zenker's diveiculum
C
Scleroderma
D
Diabetic gastroparesis
High-Yield Explanation
.OESOPHAGEAL DIVEICULUM can be of two types mainly, *Pulsion diveiculum: a. Pharyngeal pouch through Zenker's or Killian's dehiscence. b. Epiphrenic pulsion diveiculum occurs in the lower oesophagus, usually towards the right side, due to obstruction in the distal oesophagus or due to uncoordinated LOS relaxation. 2. Traction diveiculum: Occurs in mid-oesophagus or in the parabronchial region, is due to mediastinal granulomatous disease like tuberculosis. Investigations * A barium swallow is typical. * Oesophagoscopy and endosonography. * CT Chest as the final evaluation. Treatment * Treat the cause. * Excision of the diveiculum - epiphrenic diveiculectomy. * Cricopharyngeal myotomy or lower oesophageal myotomy with the antireflux procedure is usually required. Ref: SRB&;s manual of surgery,3 rd ed, pg no 751

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