RESUMO
Pharyngoesophageal diverticula are a rare anatomical abnormality and are classified in 3 types based on the area of their protrusion: Zenker diverticulum is the most common, followed by Killian-Jamieson diverticulum and the rarest, Laimer diverticulum. We report a case of a 68-year-old man who presented to our clinic with a 3-year history of moderate anemia uncovered after routine blood tests, progressive dysphagia for solids and food bolus impactions resolved spontaneously. Upper endoscopy revealed a wide-mouthed diverticulum, measuring 2-3 cm, with normal mucosa and food residue inside, just below the upper esophageal sphincter, on the left side of the esophageal wall and also hiatal hernia with diffuse mucosal bleeding. Subsequent barium swallow study showed as well a 25 mm left-sided outpouching arising from the anterolateral wall of the proximal cervical esophagus, consistent with a Killian-Jamieson diverticulum. Killian-Jamieson diverticulum is a rare condition with a highly variable clinical presentation, most often reported symptoms being dysphagia, regurgitation and globus sensation.
RESUMO
We present the case of a 71-year-old male who suffered an episode of acute renal failure caused by the uncommon association of two different diseases (Clostridioides difficile infection and McKittrick-Wheelock syndrome). He presented with hypovolemic shock, severe hypokalemia, hyponatremia, metabolic acidosis and acute renal failure; consequences of secretory diarrhea caused by a giant rectal tumor revealed from colonoscopy. The biopsy results revealed tubulo-villous adenoma with low/high grade dysplasia. After correction of electrolyte imbalances and azotemia, the patient underwent surgical resection with full subsequent recovery. In the literature review, including papers published from which January 1945 to April 2021, we found only one case-report of acute renal failure associated with Clostridioides difficile infection and McKittrick-Wheelock syndrome.