Esophagus
Nonneoplastic disorders
Diverticula

Author: Elliot Weisenberg, M.D. (see Authors page)

Revised: 15 January 2018, last major update November 2012

Copyright: (c) 2003-2018, PathologyOutlines.com, Inc.

PubMed Search: Diverticula[TI] esophagus[TI]

Cite this page: Weisenberg, E. Diverticula. PathologyOutlines.com website. http://www.pathologyoutlines.com/topic/esophagusdiverticula.html. Accessed February 22nd, 2018.
Definition / general
Types
  • 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
Drawings

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Zenker

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