Journal of Surgery Concepts & Practice >
Tracheal diverticula discovered during surgery: a report of 2 cases and literature review
Received date: 2022-10-08
Online published: 2023-10-24
To analyze the reasons why tracheal diverticula is easy to be missed or misdiagnosed in the diagnosis and treatment of thyroid tumors, and to strengthen the understanding of the clinical characteristics of the disease. The reasons of the misdiagnosis and missed diagnosis in similar cases were analyzed, and the anatomy, differential diagnosis, and examination methods by reviewing the relevant literature in the past 20 years were further analyzed. At the same time, a retrospective analysis was carried out on two recent clinical cases of tracheal diverticula discovered during surgery. Tracheal diverticula is easily confused with thyroid tumor and may be misdiagnosed for the following reasons: tracheal diverticula is asymptomatic in most patients; symptomatic tracheal diverticula has similar clinical symptoms to thyroid nodules; lack of character in imaging findings. General surgeons should improve their awareness and vigilance of tracheal diverticula. Neck CT should be listed as a routine examination before thyroid-related surgery.
Key words: Tracheal diverticula; Thyroid tumor; Radical thyroidectomy
HE Wen, GU Jianhua, XING Xujian, WENG Ziyi, FEI Jian . Tracheal diverticula discovered during surgery: a report of 2 cases and literature review[J]. Journal of Surgery Concepts & Practice, 2023 , 28(04) : 383 -387 . DOI: 10.16139/j.1007-9610.2023.04.016
| [1] | INAM H, ZAHID I, FATIMI S. Tracheal diverticulum as a rare cause of dysphagia[J]. Asian Cardiovasc Thorac Ann, 2019, 27(1):49-51. |
| [2] | CHERREZ-OJEDA I, FELIX M, VANEGAS E, et al. Pneumomediastinum, tracheal diverticulum, and pro-bable asthma: coincidence or possible association? A case report[J]. Am J Case Rep, 2018, 19:1267. |
| [3] | BOYACI N, SEN DOKUMACI D, KARAKAS E, et al. Paratracheal air cysts: prevalence and relevance to pulmonary emphysema and bronchiectasis using thoracic multidetector CT[J]. Diagn Interv Radiol, 2015, 21(1):42. |
| [4] | TANRIVERMIS SAYIT A, ELMALI M, SAGLAM D, et al. The diseases of airway-tracheal diverticulum: a review of the literature[J]. J Thorac Dis, 2016, 8(10):E1163. |
| [5] | TOSCANO L, TERRA D, SALISBURY S, et al. Surgical resection of tracheal diverticulum with haemoptysis as unusual presentation[J]. Case Rep Surg, 2019:1-3. |
| [6] | O'LEARY C N, RYAN J W, CORBETT G, et al. Barotrauma induced tracheal diverticulum rupture: imaging findings[J]. BMJ Case Rep, 2016, 2016:bcr2016217518. |
| [7] | POLAT A V, ELMALI M, AYDIN R, et al. Paratracheal air cysts: prevalence and correlation with lung diseases using multi‐detector CT[J]. J Med Imaging Radiat Oncol, 2014, 58(2):144-148. |
| [8] | GOO J M, IM J G, AHN J M, et al. Right paratracheal air cysts in the thoracic inlet: clinical and radiologic significance[J]. Am J Roentgenol, 1999, 173(1):65-70. |
| [9] | BAGHERI R, MADDAH G, MASHHADI M R, et al. Esophageal diverticula: analysis of 25 cases[J]. Asian Cardiovasc Thorac Ann, 2014, 22(5):583-587. |
| [10] | KIM M J, JUNG H, PARK C S. Incidental paratracheal air cyst in papillary thyroid cancer patient: a case report[J]. Gland Surg, 2021, 10(7):2334-2339. |
| [11] | WANG C, ZHANG Z, WU A. Tracheal diverticulum accidently found during bronchoscopy in a patient scheduled for thoracoscopic lobectomy: to perform the operation or not?[J]. Asian J Surg, 2020, 43(9):961-962. |
| [12] | 孙剑, 胡欣, 褚晓秋, 等. 气管憩室伴感染误诊为“急性化脓性甲状腺炎”1例报道并文献复习[J]. 国际内分泌代谢杂志, 2019, 39(5):353-356. |
| [12] | SUN J, HU X, CHU X Q, et al. Tracheal diverticulum with infection misdiagnosed as “acute suppurative thyroiditis”: a case report and literature review[J]. Int J Endocrinol Metabolism, 2019, 39(5):353-356. |
| [13] | 章建全, 陈红琼, 程杰, 等. 甲状腺结节热消融治疗的潜在威胁:气管憩室1例[J]. 中华超声影像学杂志, 2019,(1):85-86. |
| [13] | ZHANG J Q, CHEN H Q, CHEN J, et al. Potential threat of thermal ablation therapy for thyroid nodules: a case of tracheal diverticulum[J]. Chin J Ultrasonography, 2019,(1):85-86. |
| [14] | ELLIS J, HIGHTOWER S, HOSTLER D. Case of a tracheal diverticulum causing airway obstruction[J]. Postgrad Med J, 2019, 95(1120):104-105. |
| [15] | TANAKA H, UEMURA N, ABE T, et al. Thoracoscopic resection of esophageal cancer with a tracheal diverticulum[J]. Gen Thorac Cardiovasc Surg, 2018, 66(2):116-119. |
| [16] | LIN H, CAO Z, YE Q. Tracheal diverticulum: a case report and literature review[J]. Am J Otolaryngol, 2014, 35(4):542-545. |
| [17] | LASKER G F, RAGGIO B, KANDIL E. An expansile mass following central lymph node dissection[J]. JAMA Otolaryngol Head Neck Surg, 2016, 142(12):1237-1238. |
| [18] | 邢炜东, 武文明, 赵建东, 等. 气管憩室1例[J]. 临床耳鼻咽喉科杂志, 2003, 17(9):521. |
| [18] | XING W D, WU W M, ZHAO J D, et al. A case of tracheal diverticulum[J]. J Clin Otolaryngol, 2003, 17(9):521. |
| [19] | BAE H J, KANG E Y, YONG H S, et al. Paratracheal air cysts on thoracic multidetector CT: incidence, morphological characteristics and relevance to pulmonary emphysema[J]. Br J Radiol, 2013, 86(1021):20120218. |
| [20] | CHENG H M, CHANG P Y, CHIANG K H, et al. Prevalence and characteristics of paratracheal air cysts and their association with emphysema in a general population[J]. Eur J Radiol, 2012, 81(10):2673-2677. |
| [21] | GOUDARZI V, MOMENI M, HANAFI M G, et al. Addressing the relationship between paratracheal air cyst and paranchymal lung disease in thoracic CT-scan in patients referring to Golestan Hospital of Ahvaz[J]. J Family Med Prim Care, 2019, 8(10):3404. |
| [22] | KIM J S, KIM A Y, YOON Y. Paratracheal air cysts using low-dose screening chest computed tomography: clinical significance and imaging findings[J]. Jpn J Radiol, 2011, 29(9):644-668. |
| [23] | BUTERBAUGH J E, ERLY W K. Paratracheal air cysts: a common finding on routine CT examinations of the cervical spine and neck that may mimic pneumomediastinum in patients with traumatic injuries[J]. Am J Neuroradiol, 2008, 29(6):1218-1221. |
| [24] | GAYER G, SAROUK I, KANAANY N, et al. Tracheal diverticula in cystic fibrosis-a potentially important underreported finding on chest CT[J]. J Cyst Fibros, 2016, 15(4):503-509. |
| [25] | 赵亚春, 贺文, 金焱, 等. 气管小憩室CT表现[J]. 放射学实践, 2014,(7):778-781. |
| [25] | ZHAO Y C, HE W, JIN Y, et al. CT manifestations of tracheal diverticulum[J]. Radiol Pract, 2014,(7):778-781. |
| [26] | TEH B M, HALL C, KLEID S. Infected tracheocoele (acquired tracheal diverticulum): case report and literature review[J]. J Laryngol Otol, 2011, 125(5):540-545. |
| [27] | EARLY E K, BOTHWELL M R. Congenital tracheal diverticulum[J]. Otolaryngol Head Neck Surg, 2002, 127(1):119-121. |
| [28] | VEENKER E, COHEN J I. Current trends in management of Zenker diverticulum[J]. Curr Opin Otolaryngol Head Neck Surg, 2003, 11(3):160-165. |
| [29] | YAZAKI E, WOODLAND P, SIFRIM D. Uses of esophageal function testing: dysphagia[J]. Gastrointest Endosc Clin N Am, 2014, 24(4):643-654. |
| [30] | 阳圆圆, 赵平, 潘武, 等. 食管憩室误诊为甲状腺肿瘤1例报告[J]. 中国实用外科杂志, 2019, 39(11):1238-1239. |
| [30] | YANG Y Y, ZHAO P, PAN W, et al. Zenker's diverticulum misdiagnosed as thyroid neoplasm: a case report[J]. Chin J Pract Surg, 2019, 39(11):1238-1239. |
| [31] | 高虹, 李雪飞, 刘春芝. 咽食管憩室误诊为甲状腺肿物4例病例分析[J]. 中国实验诊断学, 2016, 20(12):2133-2134. |
| [31] | GAO H, LI X F, LIU C Z. Analysis of 4 cases of pharyngeal Zenker's diverticulum misdiagnosed as thyroid tumor[J]. Chin J Lab Diagn, 2016, 20(12):2133-2134. |
| [32] | 徐健, 吴庆梅, 文飞. 咽食管憩室超声误诊为甲状腺占位1例[J]. 临床超声医学杂志, 2016, 18(12):819. |
| [32] | XU J, WU Q M, WEN F. A case of pharyngeal Zenker's diverticulum misdiagnosed as thyroid space occupying lesion by ultrasonography[J]. J Clin Ultrasound, 2016, 18(12):819. |
| [33] | 李斌, 郑雪勇, 冯联忠, 等. Zenker憩室超声检查误诊为甲状腺结节一例[J]. 中华耳鼻咽喉头颈外科杂志, 2012, 47(9):770-771. |
| [33] | LI B, ZHEN X Y, FENG L Z, et al. Zenker diverticulum ultrasound misdiagnosed as a thyroid nodule: a case report[J]. Chin J Otorhinolaryngol Head Neck Surg, 2012, 47(9):770-771. |
| [34] | 方勇, 郭玉洋, 王媛媛. Zenker's憩室误诊为甲状腺结节1例分析[J]. 中国误诊学杂志, 2011, 11(34):8387. |
| [34] | FANG Y, GUO Y Y, WANG Y Y. Analysis of one case of Zenker's diverticulum misdiagnosed as thyroid nodule[J]. Chin J MisDiagn, 2011, 11(34):8387. |
| [35] | 高万峰, 石富, 于兰, 等. Killian-Jamieson憩室误诊为结节性甲状腺肿[J]. 临床误诊误治, 2010, 23(6):557. |
| [35] | GAO W F, SHI F, YU L, et al. Killian Jamieson diverticulum misdiagnosed as nodular Goitre[J]. Clin MisDiagn Misther, 2010, 23(6):557. |
| [36] | RASHID K, JOHNS W, CHASSE K, et al. Esophageal diverticulum presenting as metastatic thyroid mass on iodine-131 scintigraphy[J]. Clin Nucl Med, 2006, 31(7):405-408. |
| [37] | GAREFIS K, TARAZIS K, GKIOUZELIS K, et al. Multiple tracheal diverticula in a COVID-19 positive patient[J]. Ear Nose Throat J, 2021:1455613211034602. |
| [38] | 吴国庚, 潘纪戍, 刘甫庚, 等. 气管旁囊肿的CT表现[J]. 临床放射学杂志, 2003, 22(8):670-673. |
| [38] | WU G G, PAN J S, LIU F G, et al. CT manifestations of paratracheal cysts[J]. J Clin Radiol, 2003, 22(8):670-673. |
| [39] | SRIVASTAVA A, GUITRON J, WILLIAMS V A. Tracheal diverticulum: an atypical presentation[J]. J Thorac Cardiovasc Surg, 2014, 148(6):3244-3245. |
| [40] | AKABANE S, KAWACHI J, FUKAI R, et al. A rare case of an infected tracheal diverticulum requiring emergency intervention: a case report[J]. Int J Surg Case Rep, 2016, 24:7-9. |
| [41] | SMELLEY C L, BOWEN R, NATHAN C O. Intermittently symptomatic tracheal diverticulum: a case of a rare clinical phenomenon[J]. Ear Nose Throat J, 2011, 90(9):E10-E12. |
| [42] | MITCHELL A L, GANDHI A, SCOTT-COOMBES D, et al. Management of thyroid cancer: United Kingdom national multidisciplinary guidelines[J]. J Laryngol Otol, 2016, 130(S2):S150-S160. |
/
| 〈 |
|
〉 |