Case Report
Copyright ©2008 The WJG Press and Baishideng. All rights reserved.
World J Gastroenterol. Nov 14, 2008; 14(42): 6589-6592
Published online Nov 14, 2008. doi: 10.3748/wjg.14.6589
Endoscopic diverticulotomy with an isolated-tip needle-knife papillotome (Iso-Tome) and a fitted overtube for the treatment of a Killian-Jamieson diverticulum
Chang Kyun Lee, Il-Kwun Chung, Ji-Young Park, Tae Hoon Lee, Suck-Ho Lee, Sang-Heum Park, Hong-Soo Kim, Sun-Joo Kim
Chang Kyun Lee, Il-Kwun Chung, Ji-Young Park, Tae Hoon Lee, Suck-Ho Lee, Sang-Heum Park, Hong-Soo Kim, Sun-Joo Kim, Division of Gastroenterology, Department of Internal Medicine, Soonchunhyang University College of Medicine, Cheonan Hospital, Cheonan, Choongnam 330-721, South Korea
Author contributions: Lee CK, Chung IK, Lee SH and Park SH contributed the design of the study; Kim HS and Kim SJ provided the clinical advice; Chung IK performed all of the endoscopic procedures described in the paper; Park JY and Lee TH edited the manuscript; Lee CK wrote the paper.
Correspondence to: Il-Kwun Chung, MD, PhD, Division of Gastroenterology, Department of Internal Medicine, Soonchunhyang University College of Medicine, Cheonan Hospital, 23-20 Bongmyung-dong, Cheonan, Choongnam 330-721, South Korea. euschung@sch.ac.kr
Telephone: +82-41-570-3741 Fax: +82-41-574-5762
Received: September 4, 2008
Revised: October 15, 2008
Accepted: October 22, 2008
Published online: November 14, 2008
Abstract

A Killian-Jamieson diverticulum (KJD) is an unfamiliar and rare cervical esophageal diverticulum. This diverticulum originates on the anterolateral wall of the proximal cervical esophagus through a muscular gap (the Killian-Jamieson space) below the cricopharyngeal muscle and lateral to the longitudinal muscle of the esophagus. To date, only surgical treatment has been recommended for a symptomatic KJD due to its close proximity to the recurrent laryngeal nerve and the concern of possible nerve injury. Recently, traditional open surgery for a symptomatic KJD is being challenged by the development of new endoscopic techniques and devices. We present here a case of a symptomatic KJD that was successfully treated with the flexible endoscopic diverticulotomy using two new devices. An isolated-tip needle-knife papillotome (Iso-Tome) was used for the dissection of the tissue bridge of the diverticulum. And a flexible overtube with a modified distal end (a fitted overtube) was used for adequate visualization of the tissue bridge of the diverticulum and protection of the surrounding tissue during dissection of the tissue bridge. Our successful experience suggests that the flexible endoscopic diverticulotomy with the use of appropriate endoscopic devices can be a safe and effective method for the treatment of a symptomatic KJD.

Keywords: Esophagus; Diverticulum; Killian-Jamieson diverticulum; Endoscopy; Diverticulotomy