Pharyngeal Diverticulum (pouch)

Question 1

The inferior pharyngeal constrictor is split into 2 parts called…

Answer 1

Thyropharyngeus

Cricopharyngeus

Question 2

During normal swallowing what happens to the thyropharyngeus and cricopharyngeus?

Answer 2

Thyropharyngeus contracts and cricopharyngeus relaxes allowing bolus of food to be propelled into oesophagus

Question 3

How does a midline diverticulum tend to form?

Answer 3

When relaxation of cricopharyngeus does not occur (uncoordinated swallowing) - intrapharyngeal pressure rises and diverticulum forms at the weakness between the 2 parts of the inferior pharyngeal constrictor

Question 4

What can accumulate in the pouch?

Answer 4

Food

Question 5

What is the area of weakness known as?

Answer 5

Killian’s dehiscence

Question 6

What signs are associated?

Answer 6

Dysphagia with gurgling 
Regurgitation of undigested food 
Chronic cough 
Halitosis 
Lump in neck 
Hoarse voice
Recurrent chest infections (aspiration pneumonia)

Question 7

Who is it often seen in?

Answer 7

Elderly men

Question 8

What investigations an be done?

Answer 8

Barium swallow

Endoscopy - exclude malignancy in pouch

Question 9

How is it managed?

Answer 9

If symptomatic:

Diverticulectomy

Question 10

On examination, what will be observed?

Answer 10

Lump in neck, which gurgles on palpitation

Question 11

Out of the 3 pharyngeal constrictors, which is the thickest?

Answer 11

The inferior

It arises from the sides of the thyroid and cricoid cartilages