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[Zenker diverticulum Á­Ä¿ °³½Ç] - ðû

2020-4-25. ¼øõ¸¸³»½Ã°æ¼¼¹Ì³ª µ¿¿µ»ó °­ÀÇ

1. Zenker °Ô½ÇÀÇ Á¤ÀÇ, ÇغΠ¹× ¿ª»ç

2. º´Å »ý¸®

3. ¿ªÇÐ

4. Áõ»ó

5. ³»½Ã°æ ¼Ò°ß

6. Ä¡·á - Z-POEM

7. FAQs

8. References


1. Zenker °Ô½ÇÀÇ Á¤ÀÇ, ÇغΠ¹× ¿ª»ç

Cricopharyngeal muscle »ó¹æ¿¡ À§Ä¡ÇÏ°í ÁÖ¸Ó´Ï(pouch)°¡ µÚÂÊÀ¸·Î ÇâÇÏ´Â °Ô½ÇÀÌ Zenker diverticulumÀÔ´Ï´Ù. ¿·À¸·Î ºüÁö´Â °ÍÀº Killian-Jamieson diverticulumÀÔ´Ï´Ù.

óÀ½ ±â¼úÇÑ »ç¶÷Àº Lundlow¶ó´Â ºÐÀä (Med Observ Inq 1769;3:85-101), Zenker¶ó´Â ºÐÀÌ 1877³â ü°èÀûÀ¸·Î Á¤¸®ÇÑ ¸ð¾çÀÔ´Ï´Ù. ¾Æ·¡ »çÁøÀÌ Doctor ZenkerÀÔ´Ï´Ù.


2. º´Å»ý¸®

Zenker diverticulum occurs at an area of potential weakness in the inferior pharyngeal constrictor muscle referred to as the Killian dehiscence. It is located between the obliquely oriented fibers of the thyropharyngeal muscle and the horizontally oriented fibers of the cricopharyngeal muscle. Manometric examinations of patients with Zenker diverticulum have produced conflicting results, with some studies showing increased upper esophageal sphincter (UES) pressure and abnormal relaxation and others finding normal relaxation and low UES pressure. To date, no mechanism of pathogenesis has been generally accepted, although most recent studies confirm increased intrabolus pressure in patients with Zenker diverticulum.

Zenker diverticulum is associated with gastroesophageal reflux and hiatal hernia. Some studies have shown that as many as 94% of patients with pharyngeal pouches have concurrent hiatal hernias and gastroesophageal reflux. Increased UES pressure is also associated with gastroesophageal reflux, but whether the reflux, the increased UES pressure, or the Zenker diverticulum arises first in patients is controversial.

Pathologic studies of cricopharyngeal and hypopharyngeal muscle tissue resected from patients with Zenker diverticulum have shown that as many as 95% demonstrate abnormal histologic changes. These include atrophy, necrosis, hypertrophy, inflammation, and fibrosis. This muscle tissue also has been shown to have decreased anticholinesterase levels compared with those in normal tissue.


3. ¿ªÇÐ

Frequency: In the US, fluoroscopic studies of the upper GI tract have shown that the prevalence of Zenker diverticulum is 0.01-0.1%. They are present in approximately 2% of patients with nonspecific dysphagia who are referred for fluoroscopy.

Sex: slightly more common in men than in women.

Age: seen most commonly in the elderly. More than 50% of affected patients present in the seventh or eighth decade of life.

Mortality/Morbidity: Weight loss occurs in approximately one third of patients; however, this is generally modest in severity. A more serious complication occurring in approximately 30% of patients is aspiration pneumonia. Squamous cell carcinoma developing within the diverticulum is a rare complication, occurring in 0.3-0.48% of patients; however, this has a high mortality rate. Other rare complications include ulceration, esophageal obstruction, hemorrhage, tracheodiverticular fistula, and perforation.


4. Áõ»ó - ´ç¿¬È÷ ½ÉÇÒ ¶§¸¸ Ä¡·áÇÕ´Ï´Ù.

Transient dysphagia; early in the course

Pulmonary aspiration

Neck mass

Food regurgitation

Esophageal obstruction

Recurrent aspiration pneumonia


5. ³»½Ã°æ ¼Ò°ß

¸ñÀÇ ÅëÁõÀ¸·Î ³»½Ã°æ °Ë»ç¸¦ ½ÃÇàÇÏ¿© »óºÎ½ÄµµÀÇ erythematous swelling, stenosis ¼Ò°ß¸¸ ÀÖ¾ú°í Á¶Á÷°Ë»ç¿¡´Â ¿°Áõ ¼Ò°ß¸¸ ³ª¿Ô°í neck CT¿¡¼­ ¾Ï ÀǽÉÀ¸·Î ÀǷڵǽŠºÐÀÔ´Ï´Ù.

ù ³»½Ã°æ. °¡´Â ³»½Ã°æÀ¸·Î ¹Ù²Ù¾î Åë°úÇÒ ¼ö ÀÖ¾úÀ½.

ÀÇ·Ú ÈÄ ³»½Ã°æ Àç°Ë¿¡¼­ UES Á÷ÇϹ濡 blind end¸¦ ÀÌ·ç´Â pouch°¡ ÀÖ¾ú°í, ÀÌ pouchÀÇ proximal Ãø¸é¿¡ ÀÛÀº openingÀÌ °üÂûµÊ. ÀÌ ±¸¸ÛÀ» ÅëÇÏ¿© ½Äµµ true lumenÀ¸·Î µé¾î°¥ ¼ö ÀÖ¾úÀ½.

»óºÎ½Äµµ °Ô½Ç¿¡ À½½ÄÀÌ Â÷ ÀÖ°í true lumenÀ¸·Î µé¾î°¡´Â ±æÀ» ã±â ¾î·Á¿ü±â ¶§¹®¿¡ »óºÎ½ÄµµÀÇ ¾Ç¼ºÁúȯÀ¸·Î ¿ÀÀεǾú´ø °Í °°½À´Ï´Ù. °í·É ȯÀÚÀÇ »óºÎ½Äµµ Áúȯ¿¡¼­´Â ¹Ýµå½Ã diverticulumÀ» °í·ÁÇØ¾ß ÇÕ´Ï´Ù.


6. Ä¡·á


1) ¿Ü°úÀû ÀýÁ¦¼ú (laparoscopic diverticulectomy)


2) Rigid esophagoscopy¸¦ ÀÌ¿ëÇÑ endoscopic diverticulostomy

Philip Chiu. SCI 2016


3) Flexible endoscopy¸¦ ÀÌ¿ëÇÑ endoscopic diverticulostomy

³»½Ã°æÀ¸·Î °Ô½Ç°ú ½ÄµµÀÇ º®(septum)À» Á÷Á¢ ÀÚ¸£´Â ¹æ¹ýÀÔ´Ï´Ù. SeptumÀÇ ¸Ç ±âÀúºÎ±îÁö °ÅÀÇ »§±¸³ª±â Á÷Àü±îÁö ÀÚ¸£´Â °ÍÀÌ ¿äÁ¡ÀÔ´Ï´Ù. óÀ½ ½ÃµµÇÒ °æ¿ì´Â ¾Æ·¡ ±×¸²°ú °°ÀÌ ½Äµµ·Î nasogastric tube¸¦ ³Ö¾î³õ°í ÇÏ´Â °ÍÀÌ ÁÁ°Ú´Ù´Â ±ÛÀ» º»ÀûÀÌ Àִµ¥ Àú´Â nasogastric tube¸¦ »ç¿ëÇÏÁö ¾Ê°í ½ÃÇàÇصµ ÁÁ´Ù°í »ý°¢ÇÕ´Ï´Ù.

¾Æ·¡¿Í °°Àº Zenker diverticulostomy Àü¿ë capÀÌ ÀÖÀ¸¸é ÁÁ°ÚÁö¸¸ ±¸ÇÒ ¼ö ¾ø½À´Ï´Ù. ±×³É º¸Åë capÀ» ÀÌ¿ëÇÏ´Â ¼ö¹Û¿¡...

¾Æ·¡¿Í °°Àº Zenker diverticulostomy Àü¿ë tube°¡ ÀÖÀ¸¸é ´õ¾øÀÌ ÁÁ°ÚÁö¸¸ ±¸ÇÒ ¼ö ¾ø½À´Ï´Ù. ±×³É º¸Åë capÀ» ÀÌ¿ëÇÏ´Â ¼ö¹Û¿¡...

Àúµµ ¸¹ÀÌ Çغ¸Áö ¸øÇßÁö¸¸ ÇÑ ¿¹¸¦ º¸¿©µå¸®¸é ¾Æ·¡¿Í °°½À´Ï´Ù. °ÌÀÌ ³ª¼­ septumÀ» ´Ù ÀÚ¸£Áö ¸øÇߴµ¥µµ ȯÀÚÀÇ Áõ»óÀº ÇöÀúÈ÷ ÁÁ¾ÆÁ³½À´Ï´Ù. ´ç½Ã ÇÕº´ÁõÀ¸·Î subcutaneous emphysema°¡ ÀÖ¾ú´Âµ¥ À̳» ÁÁ¾ÆÁ³½À´Ï´Ù. ÀÌ ½Ã¼úÀº ºê¶óÁú¿¡¼­ °¡Àå ¸¹ÀÌ ½ÃÇàµÇ¾ú´Âµ¥, ±×µéÀÇ º¸°í¿¡ µû¸£¸é ÇÕº´ÁõÀÇ ºóµµ´Â subcutaneous emphysema°¡ 5%, ÃâÇ÷ÀÌ 3%¶ó°í ÇÕ´Ï´Ù (Mulder CJ. Endoscopy 2001).

Zenker °Ô½ÇÀ» ³»½Ã°æÀ¸·Î ÀÚ¸£´Â µ¥ °¡Àå ¾î·Á¿î Á¡À» ³»½Ã°æÀ» ¾ÈÁ¤°¨ÀÖ°Ô °íÁ¤Çϱ⠾î·Æ´Ù´Â °ÍÀÔ´Ï´Ù. ¿ÀÈ÷·Á Áߺνĵµ °Ô½ÇÀÇ septumÀº ³»½Ã°æÀ¸·Î ÀÚ¸£±â°¡ ½±½À´Ï´Ù. ¾ÈÁ¤°¨ÀÌ Àֱ⠶§¹®ÀÔ´Ï´Ù. ¾Æ·¡ »çÁøÀº Áߺνĵµ septumÀ» ÀÚ¸£´Â ¸ð½ÀÀÔ´Ï´Ù. ¸·»ó 10ºÐ Á¤µµ ¹Û¿¡ ¾È °É¸³´Ï´Ù.

Digestive Endoscopy 2015³â 11¿ùÈ£¿¡ ÀÌÅ»¸®¾Æ¿¡¼­ FB knife¸¦ ÀÌ¿ëÇÑ Zenker °Ô½Ç Ä¡·á ³í¹®À» ¹ßÇ¥ÇÏ¿´½À´Ï´Ù (Battaglia G. DE 2015). ±×³É cutting¸¸ ÇÏ´Â °ÍÀÌ º¸ÅëÀε¥ ÀÌÅ»¸®¾Æ ÀÇ»çµéÀº µÎ ¹ø cuttingÇÏ°í ±× »çÀ̸¦ snare·Î À߶óÁÖ¾ú½À´Ï´Ù. ±×¸®°í ¸Ç ¸¶Áö¸·¿¡ clipÀ» ÇØ ÁÖ¾ú³×¿ä. Áö³ªÄ¡°Ô Á¶½ÉÇÑ °Í ¾Æ´Ñ°¡ ½Í½À´Ï´Ù.

Zenker¿¡¼­ »ç¿ëÇÒ ¼ö ÀÖÀ»Áö Àǹ®ÀÌÁö¸¸ 2015³â 11¿ù È£ GutÁö¿¡ magnet¸¦ ÀÌ¿ëÇÑ ½Äµµ°Ô½Ç Ä¡·á¹ýÀÌ ¼Ò°³µÇ¾ú½À´Ï´Ù (Bouchard S. Gut 2015). °Ô½ÇÀÇ º®À» Áß°£¿¡ µÎ°í ÀÚ¼®À» À§Ä¡½ÃÅ°¸é ±×·Î ÀÎÇÏ¿© fistula°¡ »ý±é´Ï´Ù. ±× ÀÌÈÄ ³²Àº septumÀ» ³»½Ã°æÀ¸·Î ÀÚ¸£´Â ¹æ¹ýÀÔ´Ï´Ù. ÀÚ¼®À» ÀÌ¿ëÇÏÁö ¾Ê°í óÀ½ºÎÅÍ Dual knife °°Àº °ÍÀ» ÀÌ¿ëÇÏ¿© septumÀ» Àß¶óµµ ÃæºÐÇÒ °Í °°Àºµ¥... ¾Æ¹«·¡µµ ³»½Ã°æ ¼ú±â¿¡ ÀÚ½ÅÀÌ ¾ø°í °ÌÀÌ ³­´Ù¸é ÀÚ¼®ÀÇ µµ¿òÀ» ¹ÞÀ» ¼ö ÀÖ´Ù°í »ý°¢ÇÕ´Ï´Ù. °£´ÜÇÑ °ÍÀ» ±¦È÷ º¹ÀâÇÏ°Ô ÇÏ´Â ´À³¦µµ µé¾ú½À´Ï´Ù.

Endoscopy 2020³â 4¿ùÈ£ E-Videos¿¡ Zenker diverticulum septotomy µ¿¿µ»óÀÌ ½Ç·È½À´Ï´Ù (Endoscopy 2020;52:308-309). Âü°íÇϽñ⠹ٶø´Ï´Ù.


4) Z-POEM

Flexible endoscopy¿Í needle type knife¸¦ ÀÌ¿ëÇÑ Zenker diverticulum septotomyÀº ³»½Ã°æÀ» ¾ÈÁ¤ÀûÀ¸·Î À¯ÁöÇϱ⠾î·Á¿ö õ°ø À§ÇèÀÌ ÀÖ½À´Ï´Ù. ÃÖ±Ù¿¡´Â Achalasia¿¡ »ç¿ëµÇ´Â POEMÀ» Zenker °Ô½Ç Ä¡·á¿¡ Àû¿ëÇÏ°í ÀÖ½À´Ï´Ù. Z-POEMÀ̶ó ºÎ¸¨´Ï´Ù. Àú´Â ¾ÆÁ÷ ½Ã¼ú °æÇèÀÌ ¾ø¾î¼­ Facebook¿¡ ÇÑ ¼±»ý´ÔÀÌ ¼Ò°³ÇÑ ³»¿ëÀ» ¿Å±é´Ï´Ù.


[FAQ]

[2015-3-5. ¾Öµ¶ÀÚ Áú¹®]

Ç×»ó ¼±»ý´ÔÀÇ EndoTODAY·Î ¾ÆħÀ» ½ÃÀÛÇÏ°í ÀÖ½À´Ï´Ù. Àú´Â ½Ã°ñÀÇ ÀÛÀº º´¿ø ÀÇ»çÀÌÁö¸¸, ´Ù¼Ò ¿ÜÁø °÷À̾ ´Ù¾çÇÑ Áõ·Ê¸¦ Á¢ÇÏ°Ô µË´Ï´Ù. Ç×»ó ¿ì¹®¿¡ Çö´äÇØ Áֽô ¼±»ý´Ô²² ¸¹ÀÌ ¹è¿ì°í ÀÖ½À´Ï´Ù. ³Ê¹«³ª °¨»çÇÕ´Ï´Ù.

Áú¹®Àº ½Äµµ °Ô½ÇÀÔ´Ï´Ù. ƯÈ÷, ½Äµµ »óºÎ¿¡¼­ °üÂûµÇ´Â À̸¥¹Ù Zenker's diverticulum ÀÔ´Ï´Ù. ÀÌ È¯ÀÚºÐÀº °ËÁø ³»½Ã°æÁß¿¡ ½Äµµ °Ô½Ç¿¡ À½½ÄÀÌ ½×¿© ÀÖ´Â °ÍÀÌ ¹ß°ßµÇ¾ú½À´Ï´Ù. ³»½Ã°æ ÈíÀÎÀ¸·Î À½½Ä¹°À» ´Ù ²ôÁý¾î³Â½À´Ï´Ù. ȯÀÚ´Â Å©°Ô ºÒÆíÇØÇÏÁö ¾Ê½À´Ï´Ù. "°¡²û ¹¹°¡ °É¸° µí ÇØ¿ä"¶ó°í ÇÕ´Ï´Ù. ±×·¡µµ, ÀԾȿ¡, Ä¡¾Æ »çÀÌ¿¡ À½½ÄÀÌ ³¢¿© À־ °ÅºÏÇѵ¥, ½Äµµ¾È¿¡ À½½ÄÀÌ Àú¸¸Å­ °í¿©ÀÖ´Ù´Ï. ºÒÆíÇØ º¸ÀÔ´Ï´Ù.

Æç·Î¿ì ½ÃÀý¿¡ ±¸ÀÔÇÑ [¼ÒÈ­°ü Ä¡·á³»½Ã°æ ¼ú±â ¾ÆƲ¶ó½º] (Â÷Àç¸í, Á¤±â¿í ¼±»ý´Ô ¹ø¿ª)À» º¸¸é, Á¦ÀÏ ¸¶Áö¸·ÀÌ 'Á¨Ä¿°Ô½ÇÀÇ ³»½Ã°æÀû Áß°ÝÀý°³¼ú' ÀÔ´Ï´Ù. ÇÑ´Ù´Â À̾߱â´Â µé¾úÁö¸¸, º»ÀûÀº ¾ø½À´Ï´Ù. UpTodate °Ë»öÀ» Çغ¸´Ï ¼ö¼úÀûÀÎ ¹æ¹ý°ú ³»½Ã°æÀû ÀýÁ¦¼ú¿¡ ´ëÇØ ¼³¸íÀÌ ÀÖÁö¸¸, ±¸Ã¼ÀûÀÎ °¨ÀÌ Àß ¾È¿É´Ï´Ù. ¼±»ý´ÔÀÇ °æÇèÀ̳ª ÀÇ°ßÀ» ¹Ù¶ø´Ï´Ù. »çÁø¿¡ O Ç¥½Ã´Â ½Äµµ lumen ÀÌ°í * Ç¥½Ã°¡ °Ô½ÇÀÔ´Ï´Ù.

[2015-3-5. ÀÌÁØÇà ´äº¯]

ÁÁÀº Áú¹® °¨»çÇÕ´Ï´Ù. ¼±»ý´Ô²²¼­ º¸³»ÁֽŠ»çÁø¿¡¼­´Â septumÀÇ endoscopic anatomy¸¦ Á¤È®È÷ ¾Ë±â ¾î·Á¿ö Ä¡·á°èȹÀ» È®Á¤Çϱ⠾î·Æ½À´Ï´Ù. Esophagography¸¦ ½ÃÇàÇÑ ÈÄ °áÁ¤Çϼŵµ ÁÁ°Ú½À´Ï´Ù.


[2015-3-24. ¾Öµ¶ÀÚ ÀÇ°ß]

¾îÁ¦ ÀÏ¿äÀÏ Meet the professor session¿¡¼­ ±³¼ö´ÔÀ» ¿À·£¸¸¿¡ ºË°í Ç×»ó ¿­Á¤ÀûÀ̴̼ø °­ÀǸ¦ ´Ù½Ã µéÀ» ¼ö À־ ÁÁ¾Ò½À´Ï´Ù. ¿À´Ã ¸ÞÀÏÀº ´Ù¸§ÀÌ ¾Æ´Ï¶ó.. ¸î ÀÏÀü ¿£µµÅõµ¥ÀÌ ¾Öµ¶ÀÚ°¡ º¸³½ Zenker diverticulumÀ» Á¦°¡ ³ª¸§´ë·Î °ËÅäÇØ º¸´Ï »çÁøÀ¸·Î º¸³ª À§Ä¡Á¤È²À¸·Î º¸³ª Zenker°¡ ¾Æ´Ï°í Killian-Jamieson diverticulumÀÎ °Í °°½À´Ï´Ù. ³»½Ã°æ »çÁøÀ» º¸¸é, UES°¡ ¸· ¿­¸®¸é¼­ UESÁ÷ÇϹæÀÇ proximal cervical esophagusºÎÀ§ÀÎ °Í °°½À´Ï´Ù. (cf.Á¨Ä¿ °Ô½ÇÀº UESÁ÷»óºÎ ¶Ç´Â ±ÙÁ¢ºÎÀ§ÀÇ ÀεΠÁ¡¸·ÀÇ °Ô½Çµ¹Ãâ).

µÞÂÊÀ¸·Î ºüÁø °ÍÀº ZenkerÀÌ°í ¿·À¸·Î ºüÁø °ÍÀº Killian-JamiesonÀ̶ó°í ¸»¾¸ÇØ Á̴ּµ¥... Àú³ÎÀ̳ª ÇغÎÇÐÃ¥À» »ìÆ캸¸é, UES Á÷»ó¹æ ÀÎÁö ¾Æ´Ï¸é Á÷ÇϹæ ÀÎÁö°¡ ´õ Áß¿äÇÏ´Ù°í ¾ð±ÞµÇ¾î ÀÖ½À´Ï´Ù. ¼ÒÀ§ °æºÎ½Äµµ°ý¾à±Ù ºÎÀ§ ¶Ç´Â °ý¾à±Ù Á÷»óºÎ¿¡¼­ µÞÂÊÀ¸·Î ÀεÎÁ¡¸·ÀÌ ºüÁø °ÍÀÌ ZenkerÀÌ°í, UES Á÷ÇϹæÀÇ ¿·À¸·Î ½ÄµµÁ¡¸·ÀÌ ºüÁø °ÍÀÌ Killian-Jamieson diverticulum (proximal cervical diverticulum) À̶ó°í µÇ¾î ÀÖ½À´Ï´Ù. Áï, Áß¿äÇÑ Æ÷ÀÎÆ®´Â UESÁß½ÉÀ¸·Î °Ô½ÇÀ§Ä¡°¡ ÀÎÈĵΠÂÊ(Áï, ¾ö¹ÐÈ÷ ¸»Çϸé ÀεÎÁ¡¸·ÀÇ °Ô½Çµ¹Ãâ)ÀÎÁÖ ¾Æ´Ï¸é °æºÎ½Äµµ ±ÙÀ§ºÎ ÂÊ(°æºÎ ½ÄµµÁ¡¸·ÀÇ °Ô½Ç µ¹Ãâ)ÀÎÁö ¾Æ´Ò±î¿ä? ¿Ö³ÄÇϸé, ÀÌ µÎ °Ô½ÇÀº Áõ»ó¹ßÇöÀ̳ª Ä¡·á¹ý¿¡¼­ ¼­·Î ¸¹ÀÌ ´Ù¸£±â ¶§¹®ÀÔ´Ï´Ù (Zenker°¡ ÈξÀ ´õ ºÒÆí°¨ ÃÊ·¡).

Âü°í·Î Àо Àú³Î ¸î °³¸¦ º¸³»µå¸³´Ï´Ù. ±³¼ö´Ô²² °ËÅ並 ºÎŹµå¸³´Ï´Ù. ±×·³, Å« Àϱ³Â÷¿¡µµ Ç×»ó °Ç°­ÇϽʽÿä.

1) Killian-Jamieson °Ô½ÇÀÇ ¼ö¼úÀû Ä¡·á

2) Zenker's diverticula: pathophysiology, clinical presentation, and flexible endoscopic management.

3) Killian-Jamieson Diverticula: Radiographic Findings in 16 Patients

[2015-3-24. ÀÌÁØÇà ´äº¯]

Ÿ´çÇÑ ÁöÀûÀ̶ó°í »ý°¢ÇÕ´Ï´Ù. ÀÏÀü¿¡ Killian-Jamieson diverticulum Æí¿¡¼­ ¼³¸íµå¸° ¹Ù¿Í °°ÀÌ µÎ °Ô½ÇÀÇ °¡Àå ÇöÀúÇÑ Â÷ÀÌÁ¡Àº Killian-Jamieson diverticulum´Â cricopharyngeusÀÇ ¾Æ·¡ level, anterolateral aspect¿¡ ¹ß»ýÇÏ°í Zenker¡¯s diverticulumÀº cricopharyngeusÀÇ À­ level, posterior aspect¿¡¼­ ¹ß»ýÇÑ´Ù´Â Á¡ÀÔ´Ï´Ù. ¼±»ý´ÔÀÇ ÁöÀû°ú ÀúÀÇ ¼³¸íÀÌ »ç½Ç °°Àº ³»¿ëÀÔ´Ï´Ù.

ÀÏÀüÀÇ ¾Öµ¶ÀÚÀÇ »çÁøÀÌ Zenker °Ô½ÇÀÌ ¾Æ´Ï¶ó K-J °Ô½ÇÀÎ °Í °°´Ù´Â ¼±»ý´Ô ¸»¾¸¿¡ ÃæºÐÈ÷ ¼ö±àÇÕ´Ï´Ù. ÇÑ ÀåÀÇ »çÁø¸¸À¸·Î ±¸ºÐÀÌ ½±Áö ¾ÊÁö¸¸... ¾ÕÀ¸·Î ºñ½ÁÇÑ È¯ÀÚ¸¦ º¸¸é ±×³É »óºÎ½Äµµ°Ô½ÇÀ̶ó°í ¾²Áö ¾Ê°í Zenker ÂÊÀÎÁö, K-J ÂÊÀÎÁö ±¸ºÐÇÏ´Â ½Ãµµ¸¦ ÇØ º¸°Ú½À´Ï´Ù. ÁÁÀº comment °¨»çµå¸³´Ï´Ù.


[References]

1) Pyriform sinus pouch/diverticulum

2) ½Äµµ °Ô½Ç: Zenker diverticulum, Killian-Jamieson °Ô½Ç, Áߺνĵµ °Ô½Ç, ÇϺνĵµ °Ô½Ç

3) À§ °Ô½Ç

4) ½ÊÀÌÁöÀå °Ô½Ç

5) Meckel °Ô½Ç

6) ´ëÀå °Ô½Ç°ú °Ô½Ç¿°

7) Peroral endoscopic septotomy (POES) TOKYO LIVE 2022

© ÀÏ¿ø³»½Ã°æ±³½Ç ¹Ù¸¥³»½Ã°æ¿¬±¸¼Ò ÀÌÁØÇà. EndoTODAY Endoscopy Learning Center. Lee Jun Haeng.