Zenker diverticulum

Case contributed by Dr István Kui

Presentation

Dysphagia.

Patient Data

Age: 70 years

Note: This case has been tagged as "legacy" as it no longer meets image preparation and/or other case publication guidelines.

Barium

At the level of the C7/T1 an outpouching of the posterior wall of the hypopharynx is visualized.

Case Discussion

Zenker diverticulum results from herniation of the esophagus through the Killian triangle.

The Killian triangle is situated above the pharyngoesophageal junction, above the cricopharyngeal muscle.

The main mechanism promoting the formation is pulsion of the esophagus through the triangle, usually due to impaired relaxation or spasm of the cricopharyngeus muscle, which produces increased pressure in the hypopharynx.

A Zenker diverticulum may be asymptomatic, but it can also produce dysphagia, halitosis, cough or regurgitation.

In the asymptomatic type, no treatment is necessary. In the symptomatic form, it can be treated non-surgically with endoscopic techniques.

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