An unusual presentation of zenker's diverticulum

Zenker’s diverticulum: etiopathogenesis, symptoms and diagnosis. Comparison of operative methods

“…During palpation Boyce’s sign may be triggered – a noise of splashing fluid accumulated in the diverticulum. The diagnosis is based on a radiogram with barite that reveals a diverticulum filled with contrast on the side of the esophagus [14]. Esophagogastroduodenoscopy may be useful in ZD and operation conditions assessment (Figures 2–5).…”

Pharyngoesophageal Obstruction on the Killian-Laimer Triangle by Zenker’s Diverticulum: Case Report and Clinical Significance

“…Those muscles are part of the inferior pharyngeal constrictor muscle and are innervated by the plexus pharyngeus of the vagus nerve. Nevertheless, there are other weak areas around the esophagus, such as the Killian-Jamieson’s area, located between the transverse fibers of the cricopharyngeus muscle and the longitudinal fibers of the esophageal wall [ 2 , 9-13 ].…”

“…The pathophysiology of the disease is still in debate, but the most accepted hypothesis is that there is a high hypopharynx pressure on the muscles of the Killian-Laimer’s triangle, caused by fibrosis and motor dysfunction of the upper esophageal sphincter (UES), which can result in herniation of the esophagus’ mucosa and submucosa walls, forming the diverticulum. Other theories include cricopharyngeal spasms, congenital weakness of the area and gastroesophageal reflux [ 2 , 3 , 9-11 , 14 ]. The UES is constituted by the posterior surface of the thyroid and cricoid cartilages, the cricopharyngeus muscle, the thyropharyngeus muscle and the cervical portion of the esophagus.…”

“…In the third stage, the diverticulum assumes the shape of a bag with caudal orientation and becomes bigger than 1 cm, being visible all the time. In the last stage, the diverticulum is similar to the third stage, but it causes esophageal compression [ 9 ]. Furthermore, the diverticulum is classified regarding its size: < 2 cm is classified as a small diverticulum, between 2 and 4 cm is classified as an intermediate diverticulum and 4 - 6 cm is classified as a large diverticulum [ 8 ].…”

Foreign body in a Zenker’s diverticulum (looking for the lost dentures)

“…In the third stage, the diverticulum measures usually more than 1 cm, resembles a ‘pouch’, and is visible in both phases. In the last stage it additionally causes pressure on the oesophagus [5]. Its clinical manifestation may be poorly expressed (foreign body sensation in the throat, or throat irritation with a considerable amount of mucous secretion) or more turbulent (undigested food and mucus regurgitation, dysphagia in early phase of deglutition in 80–90% of cases, chronic cough in 30–40% of cases, hoarseness and halitosis, neck tumour presence in physical examination, significant weight loss and food aspiration into the airways) [1, 4].…”