Killian-Jamieson diverticulum

Case contributed by Derek Smith


Two days acutely worsening dysphagia, on a few months of deteriorating swallow. Background NF1. ? infection ? malignancy

Patient Data

Age: 80 years
Gender: Male

Lateral to the cervical esophagus there is a 55 mm pouch filled with gas and debris (presumed retained foodstuff) extending from C4-6 level on the left side. The content of this pouch indents the left side of the esophagus, with no clear channel from the lumen (a water soluble swallow study may be useful here). The superior margin of this elevates the cricoid cartilage and glottic structures (further assessment of the glottis is limited due to swallowing artefact). More inferiorly, this is deep to the left thyroid lobe, elevating the carotid space vessels. There is no definite mass in the esophagus immediately inferior to this but CT is limited in this regard. There is no significant surrounding fat stranding or inflammatory change.

No abnormal nodes in the neck or upper mediastinum. No other focal abnormality in the included aerodigestive tract, the salivary glands or other neck soft tissues. Small right thyroid nodules, which do not require further assessment or follow up.

Normal included brain parenchyma for age. Asymmetry of the right optic nerve sheath which appears thickened compared to the left.

Emphysematous change in the partially imaged lungs, which are distorted due to kyphoscoliosis. No size significant upper lobe pulmonary nodules.

Severe thoracic kyphoscoliosis. No destructive bony lesion. Multiple well circumscribed soft tissue attenuation nodules present throughout the superficial subcutaneous fat, measuring up to 15 mm, compatible with neurofibromas.

Opinion: Left lateral cervical esophageal 55 mm pouch-like structure, considered most compatible with a Killian-Jamieson diverticulum. Minimal surrounding inflammatory change.


A large lateral Killian-Jamieson esophageal diverticulum is confirmed on water contrast swallow study, with some delayed secondary transit.

Case Discussion

An example of the less common lateral esophageal diverticulum - the Killian-Jamieson diverticulum. This is in comparison with the posterior Zenker diverticulum (which occurs at the Killian dehiscence - out to confuse those learning head and neck and upper GI anatomy!).  

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