Zenker diverticulum

Case contributed by Dr Saad Ahmed Saad Hassan

Presentation

Dysphagia for 3 months upper esophagus. EGD revealed esophagitis but no obstructing lesion.

Patient Data

Age: 80 years
Gender: Female

MRI to assess cause of dysphagia

There is a pouch containing air-fluid level posterior to the upper esophagus at C6 and C7 levels. It measures 2.5x1.7x1 cm in its maximum dimensions. There is no abnormal enhancement or soft tissue components. This pouch exerts mass effect on the upper esophagus.

Barium radiography confirms a pharyngeal diverticulum. The barium suspension fills the diverticulum but also passes beyond it and the esophagus appears normal.

Case Discussion

Zenker’s diverticula are herniations of the hypopharynx through a defect in Killian’s triangle, an area bound by the inferior pharyngeal constrictor muscles and cricopharyngeus muscles.

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