Esophageal diverticulum

Last revised by Joachim Feger on 2 Aug 2024

Esophageal diverticula are sac or pouch projections arising from the esophagus.

They can occur in all ages but are more frequent in adults and elderly people.

Esophageal diverticula are either:

  • true diverticula: include all esophageal layers

  • false diverticula: contain only mucosa and submucosa herniating through the muscular layer (e.g. Zenker diverticulum)

Esophageal diverticula are classified according to the mechanism of formation into:

  • traction diverticula: occurs secondary to pulling forces on the outer aspect of the esophagus

  • pulsion diverticula: occurs secondary to increased intraluminal pressure (e.g. Zenker diverticulum)

They can be classified according to their location:

  • traction diverticula: are (true diverticula) which occur secondary to scarring, fibrosis and inflammatory processes (tuberculous adenitis) in the mediastinum pulling on the esophageal wall - e.g. Rokitansky diverticulum

  • pulsion diverticula: are usually false diverticula and occur secondary to abnormally increased intraluminal pressure against a weak esophageal segment

Cases and figures

  • Case 1: Zenker diverticulum
  • Case 2: middle traction diverticulm
  • Case 3: lower epiphrenic diverticulum
  • Case 4
  • Case 5
  • Case 6: pulsion diverticulum
  • Case 7: upper esophageal diverticulum
  • Case 8: small esophageal diverticulum
  • Case 9: Zenker diverticulum

Imaging differential diagnosis

  • Esophageal pseudodiverticulosis
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