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Zenker's Diverticulum

USU Teaching File MUTF - MedPix (2000)

View Article: MedPix Image - MedPix Topic

Affiliation: Uniformed Services University

ABSTRACT

Crycopharyngeal diverticula (Zenker's diverticula) are pulsion diverticula that result from increases in pharyngeal pressure at sites of weakness between the horizontal and oblique fibers of the inferior pharyngeal constrictor muscle in the posterior or posterolateral pharyngeal wall, just above the cricopharyngeus muscle. These diverticula were once thought to be the result of cricopharyngeal muscle spasm or incoordination, however manometric studies have disproven these theories. The suggestion now is that there is a causal relationship between Zenker's and hiatal hernias and gastroesophageal reflux. These diverticula can become very large, harboring food from days prior, causing stagnation and halitosis. The diverticula can become so large as to displace the esophagus forward, allowing a swallowed bolus to directly enter the diverticulum and overflow into the esophagus. Compression of the esophagus can alternatively occur from large diverticula, causing dysphagia or fluid overflow into the piriform fossa and creating an aspiration risk. Aspiration can lead to possible lung abscesses and bronchiectasis. Carcinoma has also been noted to occur in Zenker's. The most common GI symptoms leading to an exam of the esophagus is heartburn from GERD. Dysphagia and odynophagia (common symptoms of Zenker's) are a close second. Surgical myotomy may be the corrective action taken for large diverticula. Careful manipulation and instrumentation of the esophagus is in order to avoid the risk of diverticular rupture.

No MeSH data available.


Esophagram
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MPX2767_synpic570: Esophagram


Zenker's Diverticulum

USU Teaching File MUTF - MedPix (2000)

Esophagram
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=MPX2767&req=5

MPX2767_synpic570: Esophagram

View Article: MedPix Image - MedPix Topic

Affiliation: Uniformed Services University

ABSTRACT

Crycopharyngeal diverticula (Zenker's diverticula) are pulsion diverticula that result from increases in pharyngeal pressure at sites of weakness between the horizontal and oblique fibers of the inferior pharyngeal constrictor muscle in the posterior or posterolateral pharyngeal wall, just above the cricopharyngeus muscle. These diverticula were once thought to be the result of cricopharyngeal muscle spasm or incoordination, however manometric studies have disproven these theories. The suggestion now is that there is a causal relationship between Zenker's and hiatal hernias and gastroesophageal reflux. These diverticula can become very large, harboring food from days prior, causing stagnation and halitosis. The diverticula can become so large as to displace the esophagus forward, allowing a swallowed bolus to directly enter the diverticulum and overflow into the esophagus. Compression of the esophagus can alternatively occur from large diverticula, causing dysphagia or fluid overflow into the piriform fossa and creating an aspiration risk. Aspiration can lead to possible lung abscesses and bronchiectasis. Carcinoma has also been noted to occur in Zenker's. The most common GI symptoms leading to an exam of the esophagus is heartburn from GERD. Dysphagia and odynophagia (common symptoms of Zenker's) are a close second. Surgical myotomy may be the corrective action taken for large diverticula. Careful manipulation and instrumentation of the esophagus is in order to avoid the risk of diverticular rupture.

No MeSH data available.