Incidentally found Killian-Jamieson diverticulum due to an embedded fish bone

No prior work had resolved the specific presentation of a foreign object trapped within this rare anatomical pouch. It was already known that esophageal pouches often cause discomfort after swallowing sharp items. That uncertainty drove clinicians to rely on standard imaging when patients reported throat sensations. Prior research has shown that these small protrusions differ significantly from more common throat diverticula. This gap motivated a closer look at how such anatomical variations complicate standard diagnostic procedures. Researchers previously struggled to differentiate these specific pouches from other esophageal abnormalities during routine examinations. That lack of clarity often led to missed diagnoses when patients presented with typical foreign body symptoms. No prior work had documented this unique clinical scenario involving an embedded bone within this specific structure.

The aim of this report is to document the first known case of a Killian-Jamieson diverticulum identified through the accidental ingestion of a fish bone. This study addresses the diagnostic challenges associated with small esophageal pouches that are often missed during routine examinations. The authors seek to highlight the necessity of advanced imaging when patients report persistent foreign body sensations. By detailing this case, the researchers intend to provide a clear diagnostic pathway for clinicians encountering similar symptoms. The motivation stems from the high risk of complications, such as esophageal perforation, if such structures remain undiagnosed. The team also aims to compare the efficacy of different surgical approaches for managing these specific diverticula. This work focuses on improving clinical outcomes by emphasizing the limitations of standard endoscopic procedures. The report ultimately serves to guide medical professionals in the accurate assessment and safe treatment of these rare anatomical variations.

Review Approach involved documenting a single clinical case of an embedded fish bone within a rare esophageal pouch. The team performed an initial physical examination followed by a plain x-ray to screen for the object. Clinicians then attempted flexible esophagoscopy to visualize the throat and upper digestive tract. Upon failing to locate the bone, the staff ordered an enhanced neck computed tomography scan for better resolution. The surgical team executed a rigid esophagoscopy procedure while the patient was under general anesthesia. Following the successful extraction of the bone, the doctors conducted a pharyngoesophagogram to assess the structural integrity of the esophagus. This diagnostic sequence allowed the team to confirm the presence of the diverticulum without complications. The authors synthesized these steps to demonstrate the diagnostic pathway for similar future presentations.

Key Findings From the Literature indicate that a 52-year-old female patient presented with a persistent sensation of a foreign object after swallowing a fish bone. Initial plain x-ray imaging revealed a linear hyperopaque lesion, yet flexible esophagoscopy failed to detect the object. Enhanced neck computed tomography successfully identified an esophageal diverticulum containing the long embedded bone. The surgical team performed a rigid esophagoscopy to remove the bone under general anesthesia. Post-operative pharyngoesophagography confirmed the presence of the Killian-Jamieson diverticulum without any evidence of contrast leakage. The authors report this as the first documented instance of this specific diverticulum being discovered due to a fish bone. The findings suggest that these pouches are distinct from Zenker diverticula and require specialized management. The data demonstrate that standard endoscopic tools may miss these structures, necessitating advanced imaging for accurate diagnosis.

Synthesis and Implications suggest that clinicians should maintain high suspicion for esophageal pouches when standard endoscopic views appear normal. Authors propose that computed tomography remains a superior tool for identifying these hidden anatomical structures compared to initial screenings. The team emphasizes that any pouch discovered after accidental ingestion requires careful radiological assessment to exclude perforation. Researchers argue that small diverticula in this region present unique challenges that differ from more common Zenker diverticula. The report indicates that open surgical intervention offers a safer profile than endoscopic methods for these specific cases. Authors warn that transoral procedures carry elevated risks of damaging the recurrent laryngeal nerve. The findings imply that surgical reliability outweighs the convenience of minimally invasive techniques for this particular diagnosis. Clinicians should prioritize patient safety by selecting approaches that minimize potential nerve injury during corrective procedures.