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Esophagopharyngeal Diverticulum (Zenker)
Esophagopharyngeal Diverticulum (Zenker)
Evelyn W. K. Tang, MBBS, FRCR; Yolanda Y. P. Lee, MBChB, FRCR; Simon S. M. Wong, MBBS, FRCR
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Diagnostic Checklist

          TERMINOLOGY

          • Synonyms

            • Zenker diverticulum (ZD)
            • Pharyngeal pouch, pharyngoesophageal diverticulum, posterior hypopharyngeal diverticulum

          • Definitions

            • Pulsion diverticulum through Killian dehiscence

          IMAGING

          • General Features

            • Ultrasonographic Findings

              • Fluoroscopic Findings

                • CT Findings

                  • MR Findings

                    • Imaging Recommendations

                      DIFFERENTIAL DIAGNOSIS

                        PATHOLOGY

                        • General Features

                          • Gross Pathologic & Surgical Features

                            • Microscopic Features

                              CLINICAL ISSUES

                              • Presentation

                                • Demographics

                                  • Natural History & Prognosis

                                    • Treatment

                                      DIAGNOSTIC CHECKLIST

                                      • Consider

                                        Selected References

                                        1. Smith CD: Esophageal strictures and diverticula. Surg Clin North Am. 95(3):669-81, 2015
                                        2. Bizzotto A et al: Zenker's diverticulum: exploring treatment options. Acta Otorhinolaryngol Ital. 33(4):219-229, 2013
                                        3. Herbella FA et al: Esophageal diverticula and cancer. Dis Esophagus. 25(2):153-8, 2012
                                        4. Kim HK et al: Characteristics of Killian-Jamieson diverticula mimicking a thyroid nodule. Head Neck. 34(4):599-603, 2012
                                        5. Lixin J et al: Sonographic diagnosis features of Zenker diverticulum. Eur J Radiol. 80(2):e13-9, 2011
                                        6. Singaporewalla RM et al: Pharyngoesophageal diverticulum resembling a thyroid nodule on ultrasound. Head Neck. 33(12):1800-3, 2011
                                        7. Grant PD et al: Pharyngeal dysphagia: what the radiologist needs to know. Curr Probl Diagn Radiol. 38(1):17-32, 2009
                                        8. Buterbaugh JE et al: Paratracheal air cysts: a common finding on routine CT examinations of the cervical spine and neck that may mimic pneumomediastinum in patients with traumatic injuries. AJNR Am J Neuroradiol. 29(6):1218-21, 2008
                                        9. Ferreira LE et al: Zenker's diverticula: pathophysiology, clinical presentation, and flexible endoscopic management. Dis Esophagus. 21(1):1-8, 2008
                                        10. Joanes V et al: Pharyngoesophageal diverticulum following cervical corpectomy and plating. Case report. J Neurosurg Spine. 9(3):258-60, 2008
                                        11. Sen P et al: Pharyngeal pouch: associations and complications. Eur Arch Otorhinolaryngol. 263(5):463-8, 2006
                                        12. Aly A et al: Evolution of surgical treatment for pharyngeal pouch. Br J Surg. 91(6):657-64, 2004
                                        13. Sen P et al: Endoscopic stapling of pharyngeal pouch. J Laryngol Otol. 118(8):601-6, 2004
                                        14. Chang CY et al: Endoscopic staple diverticulostomy for Zenker's diverticulum: review of literature and experience in 159 consecutive cases. Laryngoscope. 113(6):957-65, 2003
                                        15. Colombo-Benkmann M et al: Cricopharyngeal myotomy in the treatment of Zenker's diverticulum. J Am Coll Surg. 196(3):370-7; discussion 377; author reply 378, 2003
                                        16. Hoffmann M et al: Zenker's diverticulotomy with the carbon dioxide laser: perioperative management and long-term results. Ann Otol Rhinol Laryngol. 112(3):202-5, 2003
                                        17. Maune S: Carbon dioxide laser diverticulostomy: a new treatment for Zenker diverticulum. Am J Med. 115 Suppl 3A:172S-174S, 2003
                                        18. Richtsmeier WJ: Endoscopic management of Zenker diverticulum: the staple-assisted approach. Am J Med. 115 Suppl 3A:175S-178S, 2003
                                        19. Sasaki CT et al: Association between Zenker diverticulum and gastroesophageal reflux disease: development of a working hypothesis. Am J Med. 115 Suppl 3A:169S-171S, 2003
                                        20. Scher RL: Endoscopic staple diverticulostomy for recurrent Zenker's diverticulum. Laryngoscope. 113(1):63-7, 2003
                                        21. van Overbeek JJ: Pathogenesis and methods of treatment of Zenker's diverticulum. Ann Otol Rhinol Laryngol. 112(7):583-93, 2003
                                        22. Veenker EA et al: Cricopharyngeal spasm and Zenker's diverticulum. Head Neck. 25(8):681-94, 2003
                                        23. Zaninotto G et al: Tailored approach to Zenker's diverticula. Surg Endosc. 17(1):129-33, 2003
                                        24. Gutschow CA et al: Management of pharyngoesophageal (Zenker's) diverticulum: which technique? Ann Thorac Surg. 74(5):1677-82; discussion 1682-3, 2002
                                        25. Krespi Y et al: Endoscopic treatment of Zenker's diverticulum using CO2 laser. Otolaryngol Head Neck Surg. 127(4):309-14, 2002
                                        26. Mirza S et al: A retrospective review of pharyngeal pouch surgery in 56 patients. Ann R Coll Surg Engl. 84(4):247-51, 2002
                                        27. Raut VV et al: Long-term results of endoscopic stapling diverticulotomy for pharyngeal pouches. Otolaryngol Head Neck Surg. 127(3):225-9, 2002
                                        28. Rubesin SE et al: Killian-Jamieson diverticula: radiographic findings in 16 patients. AJR Am J Roentgenol. 177(1):85-9, 2001
                                        29. Siddiq MA et al: Pharyngeal pouch (Zenker's diverticulum). Postgrad Med J. 77(910):506-11, 2001
                                        30. Bradley PJ et al: Pharyngeal pouch carcinoma: real or imaginary risks? Ann Otol Rhinol Laryngol. 108(11 Pt 1):1027-32, 1999
                                        Related Anatomy
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                                        Related Differential Diagnoses
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                                        References
                                        Tables

                                        Tables

                                        KEY FACTS

                                        • Terminology

                                          • Imaging

                                            • Top Differential Diagnoses

                                              • Diagnostic Checklist

                                                TERMINOLOGY

                                                • Synonyms

                                                  • Zenker diverticulum (ZD)
                                                  • Pharyngeal pouch, pharyngoesophageal diverticulum, posterior hypopharyngeal diverticulum

                                                • Definitions

                                                  • Pulsion diverticulum through Killian dehiscence

                                                IMAGING

                                                • General Features

                                                  • Ultrasonographic Findings

                                                    • Fluoroscopic Findings

                                                      • CT Findings

                                                        • MR Findings

                                                          • Imaging Recommendations

                                                            DIFFERENTIAL DIAGNOSIS

                                                              PATHOLOGY

                                                              • General Features

                                                                • Gross Pathologic & Surgical Features

                                                                  • Microscopic Features

                                                                    CLINICAL ISSUES

                                                                    • Presentation

                                                                      • Demographics

                                                                        • Natural History & Prognosis

                                                                          • Treatment

                                                                            DIAGNOSTIC CHECKLIST

                                                                            • Consider

                                                                              Selected References

                                                                              1. Smith CD: Esophageal strictures and diverticula. Surg Clin North Am. 95(3):669-81, 2015
                                                                              2. Bizzotto A et al: Zenker's diverticulum: exploring treatment options. Acta Otorhinolaryngol Ital. 33(4):219-229, 2013
                                                                              3. Herbella FA et al: Esophageal diverticula and cancer. Dis Esophagus. 25(2):153-8, 2012
                                                                              4. Kim HK et al: Characteristics of Killian-Jamieson diverticula mimicking a thyroid nodule. Head Neck. 34(4):599-603, 2012
                                                                              5. Lixin J et al: Sonographic diagnosis features of Zenker diverticulum. Eur J Radiol. 80(2):e13-9, 2011
                                                                              6. Singaporewalla RM et al: Pharyngoesophageal diverticulum resembling a thyroid nodule on ultrasound. Head Neck. 33(12):1800-3, 2011
                                                                              7. Grant PD et al: Pharyngeal dysphagia: what the radiologist needs to know. Curr Probl Diagn Radiol. 38(1):17-32, 2009
                                                                              8. Buterbaugh JE et al: Paratracheal air cysts: a common finding on routine CT examinations of the cervical spine and neck that may mimic pneumomediastinum in patients with traumatic injuries. AJNR Am J Neuroradiol. 29(6):1218-21, 2008
                                                                              9. Ferreira LE et al: Zenker's diverticula: pathophysiology, clinical presentation, and flexible endoscopic management. Dis Esophagus. 21(1):1-8, 2008
                                                                              10. Joanes V et al: Pharyngoesophageal diverticulum following cervical corpectomy and plating. Case report. J Neurosurg Spine. 9(3):258-60, 2008
                                                                              11. Sen P et al: Pharyngeal pouch: associations and complications. Eur Arch Otorhinolaryngol. 263(5):463-8, 2006
                                                                              12. Aly A et al: Evolution of surgical treatment for pharyngeal pouch. Br J Surg. 91(6):657-64, 2004
                                                                              13. Sen P et al: Endoscopic stapling of pharyngeal pouch. J Laryngol Otol. 118(8):601-6, 2004
                                                                              14. Chang CY et al: Endoscopic staple diverticulostomy for Zenker's diverticulum: review of literature and experience in 159 consecutive cases. Laryngoscope. 113(6):957-65, 2003
                                                                              15. Colombo-Benkmann M et al: Cricopharyngeal myotomy in the treatment of Zenker's diverticulum. J Am Coll Surg. 196(3):370-7; discussion 377; author reply 378, 2003
                                                                              16. Hoffmann M et al: Zenker's diverticulotomy with the carbon dioxide laser: perioperative management and long-term results. Ann Otol Rhinol Laryngol. 112(3):202-5, 2003
                                                                              17. Maune S: Carbon dioxide laser diverticulostomy: a new treatment for Zenker diverticulum. Am J Med. 115 Suppl 3A:172S-174S, 2003
                                                                              18. Richtsmeier WJ: Endoscopic management of Zenker diverticulum: the staple-assisted approach. Am J Med. 115 Suppl 3A:175S-178S, 2003
                                                                              19. Sasaki CT et al: Association between Zenker diverticulum and gastroesophageal reflux disease: development of a working hypothesis. Am J Med. 115 Suppl 3A:169S-171S, 2003
                                                                              20. Scher RL: Endoscopic staple diverticulostomy for recurrent Zenker's diverticulum. Laryngoscope. 113(1):63-7, 2003
                                                                              21. van Overbeek JJ: Pathogenesis and methods of treatment of Zenker's diverticulum. Ann Otol Rhinol Laryngol. 112(7):583-93, 2003
                                                                              22. Veenker EA et al: Cricopharyngeal spasm and Zenker's diverticulum. Head Neck. 25(8):681-94, 2003
                                                                              23. Zaninotto G et al: Tailored approach to Zenker's diverticula. Surg Endosc. 17(1):129-33, 2003
                                                                              24. Gutschow CA et al: Management of pharyngoesophageal (Zenker's) diverticulum: which technique? Ann Thorac Surg. 74(5):1677-82; discussion 1682-3, 2002
                                                                              25. Krespi Y et al: Endoscopic treatment of Zenker's diverticulum using CO2 laser. Otolaryngol Head Neck Surg. 127(4):309-14, 2002
                                                                              26. Mirza S et al: A retrospective review of pharyngeal pouch surgery in 56 patients. Ann R Coll Surg Engl. 84(4):247-51, 2002
                                                                              27. Raut VV et al: Long-term results of endoscopic stapling diverticulotomy for pharyngeal pouches. Otolaryngol Head Neck Surg. 127(3):225-9, 2002
                                                                              28. Rubesin SE et al: Killian-Jamieson diverticula: radiographic findings in 16 patients. AJR Am J Roentgenol. 177(1):85-9, 2001
                                                                              29. Siddiq MA et al: Pharyngeal pouch (Zenker's diverticulum). Postgrad Med J. 77(910):506-11, 2001
                                                                              30. Bradley PJ et al: Pharyngeal pouch carcinoma: real or imaginary risks? Ann Otol Rhinol Laryngol. 108(11 Pt 1):1027-32, 1999