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 21 March 2018

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Webs and pouches

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Pharyngeal pouch.
A 91-year-old woman with a long history of dysphagia. She was admitted with a pneumonia, which was thought to be secondary to aspiration. A contrast study showed a large pharyngeal pouch. She was fed via a naso-enteric feeding tube whilst recovering from her pneumonia. The pouch was dealt with endoscopically.

This photograph shows the Weedra scope in position with the blades partially widened and the cricopharyngeal 'bar' on display. The white tube to the left of the photograph is the naso-enteric feeding tube. The bar is divided with an endostapling device. The open jaws can be seen in the second photograph. The third photograph shows the stapled and divided bar. The pouch can now drain freely into the oesophagus.

Comment: In patients with pouches of suitable size, the endoscopic stapling technique is a convenient, effective, and relatively safe method of dealing with the problem, avoiding the need for open surgery.


Peter Devitt, Adelaide, Australia

Pharyngeal pouch.

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