ZENKER DIVERTICULUM Flashcards
what is zenker diverticulum also known as?
pharyngoesophageal false diverticulum
what is zenker diverticulum?
acquired mucosal herniation that forms in the hypopharynx
what does zenker diverticulum NOT involve?
does not involve muscle
what does zenker diverticulum involve?
mucosa and submucosal layers
what is the age you will see this condition in?
> 40
what is the main pathophysiology of zenker diverticulum ?
there is impaired relaxation of the cricopharyngeal muscle
what are the 3 resulting things of an impaired cricopharyngeal muscle in zenker diverticulum?
- pharyngeal muscles must contract more forcefully to propel food to the esophagus
- increase pressure in the hypopharynx
- herniation of mucosa and submucosa through an area with muscle weakness creating a pouch-like structure outside the lumen of esophagus
where is the most common location for a zenker diverticulum?
AT THE KILLIAN’S TRIANGLE between thyropharyngeus and cricopharyngeus muscles
what is the clinical presentation of zenker diverticulum?
retention of food particles and salivary secretions leading to
1. DYSPHAGIA- “high dysphagia”
2. REGURGITATION-> ASPIRATION
3. HALITOSIS
4. chronic cough
5. wt loss
6. visible lump in neck (rare)
7. sensation of food stuck in throat
what is the #1 dx study?
barium swallow study
what happens during a barium swallow study with zenker diverticulum?
-diverticulum fills with contrast media
-allows for assessment of size, location, and character of mucosal lining
what 2nd dx study can you do?
upper endoscopy
what is the treatment option for lesions <2cm
rarely rq tx
what is the tx option for large, symptomatic diverticulum?
- cricopharyngeal myotomy
- diverticulopexy
