Reviewer: Elliot Weisenberg, M.D. (see Reviewers page)
Revised: 13 June 2013, last major update November 2012
Copyright: (c) 2003-2013, PathologyOutlines.com, Inc.
- Outpouching of alimentary tract containing all visceral layers (eMedicine (Zenker's))
- May cause obstruction, aspiration pneumonia, abscess, infection, hemorrhage or be associated with malignancy
- Zenker's diverticula: also called pharyngoesophageal or pulsion diverticula; most common esophageal diverticula (~70%), more common in elderly; above upper esophageal sphincter, usually posterior wall; due to disordered cricopharyngeal motor dysfunction or weakness in esophageal wall at junction with pharynx; at junction between the pharynx and esophagus (known as the Killian triangle), may accumulate food, cause regurgitation or aspiration pneumonia or simulate a neck mass; malignancy in 0.3%
- Mid-esophageal/traction diverticula: near mid esophagus at level of tracheal bifurcation; becoming uncommon; previously mostly due to tuberculosis, mediastinal lymphadenitis and scarring; may be due to motor dysfunction, congenital or alkali ingestion (Med Hypotheses 2004;62:931); better prognosis than distal disease (Dysphagia 2006;21:198)
- Epiphrenic diverticula: rare; immediately above lower esophageal sphincter (LES); due to lack of coordination of peristalsis and LES relaxation (Am J Surg 2005;190:891); often associated with hiatal hernia, may cause nocturnal regurgitation of massive amounts of fluid, obstruction, aspiration; contains mucosa, submucosa and muscularis mucosae; lined by squamous epithelium, often markedly inflamed
- False or pseudo-diverticula: mucosa and submucosa only, rare, usually with diffuse esophageal spasm
Epiphrenic: defect in
esophageal wall causes
arterial perforation (rare)
End of Esophagus > Non-neoplastic disorders > Diverticula
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