robin082006
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A 76-year old man, with multi-infarct dementia, is brought to the hospital because of deterioration of his condition. His relatives state that he has been lethargic in the recent days. His vital signs are, PR: 120/min; BP: 150/95mm Hg; RR: 26/min; Temperature: 37.8C(101.5F). Past medical histroy is remarkable for hypertension for 15 yrs, chronic atrial fibrillation for 7 yrs, dementia for 5 yrs, and frequent respiratory infections for the last year. For the last 6-months, he has had difficulties with feeding and not infrequently undigested food has drooled out of his mouth and nose during meals. Physical exam is remarkable for foul smelling breath, fluctuating mass in the left side of his neck and crackles in the right lung base. Chest x-ray reveals multiple infiltrates, without cavitation in the right lower lung field. The patient is admitted, sputum and blood cultures are sent, and antibiotics are started. What should be planned next?
A. Puncture of the neck mass
B. Esophagoscopy
C. Esophagography
D. Bronchoscopy
E. CT of the neck
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| prathapdoctor
Forum Elite
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its Zenkers diverticulam,so esophagography has to be done to exclude that before proceeding to any other investigation.
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| dr.wad
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yes ( C ) _ oesophagography.
it is pharyngeal pouch.
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| chemamr
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C
looks like Zenker diverticulum.
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| robin082006
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You got it
this is Zenker diverticulum
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