Esophageal Diverticulum

Question 1

What is the most common site for esophageal diverticula?

Answer 1

Cervical Esophagus

Question 2

What causes pulsion diverticula to develop?

Answer 2

A motility abnormality found distal to diverticula

Question 3

Are pulsion or traction forces the most common cause of esophageal diverticula?

Answer 3

Pulsion

Question 4

What is a Zenker diverticulum?

Answer 4

A pulsion diverticula secondary to a dysfunctional cricopharyngeus muscle - this results in herniation of esophageal mucosa through weak points within the pharyngeal musculature.

Question 5

What is the necessary surgical treatment for Zenker’s diverticula?

Answer 5

Esophageal myotomy must be performed, with or without diverticulectomy or diverticulopexy because of the underlying cricopharyngeal muscle dysfunction.

Question 6

What is the best imaging study to evaluate esophageal diverticula?

Answer 6

Barium swallow and video swallow

Question 7

What is the role of manometry in Zenker’s diverticulum?

Answer 7

None, however in mid or distal esophageal diverticula, it should be used to assess abnormalities of esophageal motility.

Question 8

What conditions contribute to cricopharyngeus muscle dysfunction?

Answer 8

Neurological damage (eg after stroke/trauma), cervical spine injuries after procedures, scarring or fibrosis, and radiation therapy.

Question 9

What is the preferred (traditional) procedure for Zenker’s diverticulum?

Answer 9

Cervical cricopharyngeal myotomy, and diverticulectomy or diverticulopexy

Question 10

How does Zenker diverticulum often present?

Answer 10

Dysphagia, halitosis and regurgitation