Other nonneoplastic

Topic Completed: 1 November 2012

Minor changes: 9 September 2019

Copyright: 2003-2019,, Inc.

PubMed Search: Diverticula[TI] esophagus[TI]

Elliot Weisenberg, M.D.
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Page views in 2020 to date: 776
Cite this page: Weisenberg E. Diverticula. website. Accessed August 10th, 2020.
Definition / general
  • Zenker 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 pseudodiverticula: mucosa and submucosa only, rare, usually with diffuse esophageal spasm
Case reports

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Gross images

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Zenker diverticula

Epiphrenic diverticula

Epiphrenic: defect in
esophageal wall causes
arterial perforation (rare)

Microscopic (histologic) images

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Epiphrenic diverticulum

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