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.