Zenker's diverticulum
Background
- An out-pouching of the pharyngeal mucosa and submucosa through the cricopharyngeus muscle
- Classified as false diverticulum in that it does not contain all layers of the intestinal wall, but only the mucosa and submucosa
Clinical Features
- Dysphagia
- Globus sensation
- Regurgitation of undigested food
- Halitosis
Differential Diagnosis
Dysphagia
- Oropharyngeal dysphagia
- CVA
- Parkinson's disease
- Brain stem tumors
- Degenerative disease - ALS, MS, Huntington's
- Postinfectious - polio, syphilis
- Peripheral neuropathy
- Myasthenia gravis
- Polymyositis, dermatomyositis
- Muscular dystrophy
- Esophageal dysphagia
- Achalasia
- Diffuse esophageal spasm
- Ingested foreign body
- Esophageal web
- Malignancy, mediastinal masses
- Schatzki Ring
- Scleroderma
- Strictures - peptic, radiation, chemical, medication-induced
- Vascular compression
- Zenker's diverticulum
Evaluation
- Barium swallow
- Rule out emergent causes of symptoms
Management
- Often not treated, but surgery considered in some cases of particularly symptomatic diverticula[1]
Disposition
- Discharge