Esophageal (traction) diverticulum
Citation, DOI & case data
Presentation
Dysphagia in the upper esophagus. Regurgitating old tablets and food.
Patient Data
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Outpouching of the posterior aspect of the middle third of the esophagus fills with barium and air. Spontaneous empyting is observed.
4 case questions available
Q: What are the three types of oesophageal diverticulae? show answer
A: 1. Zenker (upper third) 2. Traction/Pulsion (middle third) 3. Epiphrenic (lower third)
Q: Upper oesophageal diverticulae occur at what anatomical site? show answer
A: Zenker's diverticulae occur at Killian's dehiscence (between the inferior constrictor and cricopharyngeus).
Q: Are pulsion oesophageal diverticulae "true" diverticulae? show answer
A: No (only mucosa and submucosa). True diverticulae consist of all three mural layers: 1. Mucosa / submucosa 2. Muscularis propria 3. Adventitia
Q: What is the difference between pulsion and traction diverticulae? What might have caused this patients diverticulum? show answer
A: Pulsion diverticulae are caused by increased intraluminal oesophageal pressure. Traction diverticulae are caused by fibrosis in adjacent tissue (and are usually true diverticula). This patient appears to have a traction divertciulum and is likely due to tuberculous adenitis or previous surgery leading to para-oesophageal fibrosis.
Case Discussion
Patient was being investigated for dysphagia and reported regurgitating old tablets and food.
Barium swallow also demonstrated a large Zenker diverticulum of the upper esophagus (images not shown).
References
- Jang KM, Lee KS, Lee SJ et-al. The spectrum of benign esophageal lesions: imaging findings. Korean J Radiol. 2003;3 (3): 199-210. Free text at pubmed - Pubmed citation
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