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Pharyngeal Pouch

A pharyngeal pouch is a small pocket arising between the muscles that constitute the wall of the throat, above the level of the Adams apple (So the upper throat rather than the oesophagus). At this point there is a natural weakness in the pharyngeal wall which over many years can become a bulge and then a pocket into which food can detour its way down the swallowing tube. Food then becomes trapped in the pocket until such time as it empties (sometimes when pressed on) and then the food is often regurgitated or causes aspiration and coughing as it then has a tendency to “go down the wrong way”. Pharyngeal pouches can make intubation at upper GI endoscopy more difficult as there is a tendency for the endoscope to enter the pouch rather than the oesophagus.

Usually pharyngeal pouches are diagnosed on a special x-ray known as a barium swallow. They can then be treated by surgical intervention at which ear nose and throat surgeons seal off the entrance to the pouch, usually using staples. It is important when considering surgery of this kind to choose a surgeon wo does sufficient volume of this kind of operation to enable them to have perfected the technique. How many of these have you done this year is always a telling question to ask of any person undertaking a procedure.

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