Zenker's Diverticulum

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Overview

A Zenker's Diverticulum, sometimes referred to as a pharyngeal pouch, is a herniation of esophageal mucosa through the posterior pharyngeal wall between the thyropharyngeus and cricopharyngeus muscles.

History

The Zenker's diverticulum is named after Friedrich Albert von Zenker (1825–1898), a German pathologist who served as the dean of the medical faculty and prorector at the University of Erlangen.[1]

Pathophysiology

Relevant Anatomy

Zenker's diverticulum occurs as a result of a herniation of the esophageal mucosa through Killian's triangle. Killian's triangle is bounded superiorly by the inferior pharyngeal constrictor muscle (specifically the thyropharyngeus muscle) and inferiorly by the cricopharyngeus muscle.

Disease Etiology

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Histology

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Diagnosis

Patient History

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Physical Examination

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Laboratory Tests

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Imaging

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Differential Diagnosis

Other diverticula of the pharyngeal and esophageal mucosa should be considered:

Management

Medical Management

There is no medical management that will significantly impact the development or worsening of a Zenker's diverticulum. Medical management would be limited to the treatment of sequelae of the diverticulum, such as aspiration pneumonia.

Surgical Management

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Outcomes

Complications

The main complication associated with a Zenker's Diverticulum is aspiration secondary to reflux of contents of the diverticulum. Patients will also often complain of halitosis.

Prognosis

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References

  1. Haubrich, W. S. (2004). Von Zenker of Zenker’s diverticulum1. Gastroenterology, 126(5), 1269.