Diagnostic approach and treatment of Zenker's diverticulum
DOI:
https://doi.org/10.18203/2320-6012.ijrms20242236Keywords:
Zenker's diverticulum, Esophageal diverticulum, Pharyngeal muscles, Cricopharyngeal myotomyAbstract
Pharyngoesophageal diverticulum have many subtypes, Zenker's diverticulum being the most common of them. Accounting from 70 to 75% of all esophageal diverticula. The 50% of these occur between the seventh and eighth decade of life. The most common symptom is dysphagia. The predominant symptom of ZD is dysphagia and the most serious is pulmonary aspiration. A 68-year-old female attended a general surgery consultation with progressive dysphagia, weight loss, regurgitation and halitosis. Laboratory studies showed normal, while the upper gastrointestinal series (UGI) showed stasis in the upper part of the esophagus. Digestive panendoscopy revealed Zenker's diverticulum, diverticulectomy and cricopharyngeal myotomy were performed. Zenker's diverticulum is diagnosed through radiological studies and endoscopy. Surgical management is necessary due to the list of complications if left untreated.
Metrics
References
Johnson CM, Postma GN. Not all pharyngeal pouches are created equal: management of “non-Zenker” hypopharyngeal diverticula. Oper Tech Otolaryngol Head Neck Surg. 2016;27:80-5.
Watemberg S, Laudau O, Avrahami R. Zenker’s diverticulum: reappraisal. Am J Gastroenterol. 1996;91:1494-8.
Stewart KE, Smith DRK, Woolley SL. Simultaneously occurring Zenker's diverticulum and Killian-Jamieson diverticulum: case report and literature review. J Laryngol Otol. 2017;131(8):661-6.
Yuan Y, Zhao YF, Hu Y. Surgical treatment of Zenker’s diverticulum. Dig Surg. 2013;30:214-25.
Boysen M, Aasen S, Lotveit T, Bakka A. Two simultaneously occurring hypopharyngo-oesophageal diverticula. J Laryngol Otol. 1993;107:49-50.
Bizzotto A, Iacopini F, Landi R, Costamagna G. Zenker’s diverticulum: exploring treatment options. Acta Otorhinolaryngol Ital. 2013;33:219-29.
Ferreira LE, Simmons DT, Baron TH. Zenker’s diverticula: pathophysiology, clinical presentation, and flexible endoscopic management. Dis Esophagus. 2008;21:1-8.
Van Overbeek JJ. Meditation on the pathogenesis of hypopharyngeal (Zenker’s) diverticulum and a report of endoscopic treatment in 545 patients. Ann Otol Rhinol Laryngol. 1994;103:178-85.
Van Overbeek JJ. Pathogenesis and methods of treatment of Zenker’s diverticulum. Ann Otol Rhinol Laryngol. 2003;112:583-93.
Siddiq MA, Sood S, Strachen D. Pharyngeal pouch (Zenker’s diverticulum). Postgrad Med J. 2001;77:506-11.
Laing MR, Murthy P, Ah-See KW, Cockburn JS. Surgery for pharyngeal pouch: audit of management with short- and long-term followup. J R Coll Surg Edinb. 1995;40:315-8.
Odemis B, Ataseven H, Basar O, Ertugrul I, Yüksel O, Turhan N. Ulcer in the basis of Zenker’s diverticulum mimicking esophageal malignancy. J Natl Med Assoc. 2006;98:1177-80.
Bradley PJ, Kochaar A, Quraishi MS. Pharyngeal pouch carcinoma: real or imaginary risks? Ann Otol Rhinol Laryngol. 1999;108:1027-32.
Boutou AK, Trigonis I, Pigadas A, Argyropoulou P, Stanopoulos I. Exogenous lipoid pneumonia complicated with mycobacterium infection in a subject with Zenker diverticulum. Ann Acad Med Singapore. 2009;38:177-8.
Onwugbufor MT, Obirieze AC, Ortega G, Allen D, Cornwell EE 3rd, Fullum TM: Manejo quirúrgico del divertículo esofágico: una revisión de la base de datos de muestras de pacientes hospitalizados a nivel nacional. J Surg Res. 2013;184:120-5.
Rosales-Castañeda E, García-Morán GC, Martínez-Ordaz JL. Surgical treatment of Zenker’s diverticulum. Cir Cir. 2018;86(4):355-8.
Verdonck J, Morton RP. Systematic review on treatment of Zenker’s diverticulum. Eur Arch Otorhinolaryngol. 2015;272:3095-107.
Mulder CJ, den Hartog G, Robijn RJ, Thies JE. Flexible endoscopic treatment of Zenker’s diverticulum: a new approach. Endoscopy. 1995;27:438-42.
Case DJ, Baron TH. Flexible endoscopic management of Zenker diverticulum: the Mayo Clinic experience. Mayo Clin Proc. 2010;85:719-22.
Berger MH, Weiland D, Tierney WS, Bryson PC, Weissbrod PA, Shah PV, et al. Surgical management of recurrent Zenker's diverticulum: A multi-institutional cohort study. Am J Otolaryngol. 2021;42(1):102755.
Yuan Y, Zhao YF, Hu Y, Chen LQ. Surgical treatment of Zenker’s diverticulum. Dig Surg. 2013;30:214-25.
Wang NK, Molin NL, Soliman AMS. Postoperative management of Zenker's diverticulum: Results of the American Bronchoesophagological Association survey. Am J Otolaryngol. 2022;43(5):103602.
Downloads
Published
How to Cite
Issue
Section
