Zenker diverticulum (cine of incomplete relaxation of cricopharyngeus)
Dysphagia. Patient had Alzheimer's dementia and directed questioning about symptoms was unrevealing.
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On this modified barium swallow study, there is a persisting posterior pharyngeal pouch, compatible with a Zenker diverticulum.
On the cinefluoroscopic images, the incompletely relaxing cricopharyngeus muscle is well seen and the resulting pressure on the posterior wall of the lower pharynx that results in the Zenker diverticulum is evident.
There is also a small anterior cervical esophageal web that can be seen transiently with each swallow.