Infected and fistulized Killian-Jamieson diverticulum

Case contributed by Dr Ammar Haouimi


Chronic dysphagia becomes painful with halitosis the last two weeks

Patient Data

Age: 30 years
Gender: Female

The enhanced CT with oral opacification demonstrate a left-sided esophageal outpouching anterolateral to esophagus and below the level of the cricopharyngeal muscle, containing food debris, and air-bubbles with thick enhancing wall. The adjacent left thyroid lobe shows a fluid collection with air-bubbles. The communication with the pharyngo-esophageal junction is well-visualized on the enlarged axial images. 

Case Discussion

CT features are consistent with an infected Killian-Jamieson diverticulum fistulized towards the left thyroid lobe, which was confirmed at surgery.

Killian-Jamieson diverticulum is rare esophageal outpouching arising from the lateral wall of the proximal cervical esophagus; inferior to the cricopharyngeus muscle 1. It represents an outpouching of mucosa through a muscular defect, The most common symptoms are dysphagia, cough and epigastric pain 1

It is distinct from the more commonly known Zenker diverticulum which is seen in the posterior wall of the pharynx 1. Barium esophagography and CT scan are useful to confirm the diagnosis and differentiate between both diverticula 1. The treatment is surgical (transcutaneous diverticulectomy +/- oesophagomyotomy) 1.

Additional contributor ZE. Boudiaf; MD CHU Constantine; Algeria.

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Case information

rID: 68343
Published: 28th May 2019
Last edited: 30th May 2019
System: Head & Neck
Inclusion in quiz mode: Included
Institution: Aurès Medical Imaging Center - Batna Algeria

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