Zenker's diverticulum: Difference between revisions

Jump to navigation Jump to search
No edit summary
No edit summary
Line 1: Line 1:
__NOTOC__
__NOTOC__
{{SI}}
{{Infobox_Disease |
{{Infobox_Disease |
   Name          = Zenker's diverticulum |
   Name          = Zenker's diverticulum |
Line 15: Line 14:
   MeshID        = D016672 |
   MeshID        = D016672 |
}}
}}
{{SI}}
{{CMG}}
{{CMG}}



Revision as of 13:52, 30 July 2012

Zenker's diverticulum
ICD-10 K22.5
ICD-9 530.6
DiseasesDB 31174
eMedicine med/2777 
MeSH D016672

WikiDoc Resources for Zenker's diverticulum

Articles

Most recent articles on Zenker's diverticulum

Most cited articles on Zenker's diverticulum

Review articles on Zenker's diverticulum

Articles on Zenker's diverticulum in N Eng J Med, Lancet, BMJ

Media

Powerpoint slides on Zenker's diverticulum

Images of Zenker's diverticulum

Photos of Zenker's diverticulum

Podcasts & MP3s on Zenker's diverticulum

Videos on Zenker's diverticulum

Evidence Based Medicine

Cochrane Collaboration on Zenker's diverticulum

Bandolier on Zenker's diverticulum

TRIP on Zenker's diverticulum

Clinical Trials

Ongoing Trials on Zenker's diverticulum at Clinical Trials.gov

Trial results on Zenker's diverticulum

Clinical Trials on Zenker's diverticulum at Google

Guidelines / Policies / Govt

US National Guidelines Clearinghouse on Zenker's diverticulum

NICE Guidance on Zenker's diverticulum

NHS PRODIGY Guidance

FDA on Zenker's diverticulum

CDC on Zenker's diverticulum

Books

Books on Zenker's diverticulum

News

Zenker's diverticulum in the news

Be alerted to news on Zenker's diverticulum

News trends on Zenker's diverticulum

Commentary

Blogs on Zenker's diverticulum

Definitions

Definitions of Zenker's diverticulum

Patient Resources / Community

Patient resources on Zenker's diverticulum

Discussion groups on Zenker's diverticulum

Patient Handouts on Zenker's diverticulum

Directions to Hospitals Treating Zenker's diverticulum

Risk calculators and risk factors for Zenker's diverticulum

Healthcare Provider Resources

Symptoms of Zenker's diverticulum

Causes & Risk Factors for Zenker's diverticulum

Diagnostic studies for Zenker's diverticulum

Treatment of Zenker's diverticulum

Continuing Medical Education (CME)

CME Programs on Zenker's diverticulum

International

Zenker's diverticulum en Espanol

Zenker's diverticulum en Francais

Business

Zenker's diverticulum in the Marketplace

Patents on Zenker's diverticulum

Experimental / Informatics

List of terms related to Zenker's diverticulum

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Please Take Over This Page and Apply to be Editor-In-Chief for this topic: There can be one or more than one Editor-In-Chief. You may also apply to be an Associate Editor-In-Chief of one of the subtopics below. Please mail us [2] to indicate your interest in serving either as an Editor-In-Chief of the entire topic or as an Associate Editor-In-Chief for a subtopic. Please be sure to attach your CV and or biographical sketch.

Overview

In anatomy, Zenker's diverticulum is a diverticulum of the mucosa of the pharynx, just above the cricopharyngeal muscle (i.e. above the upper sphincter of the oesophagus). It was named in 1877 by German pathologist Friedrich Albert von Zenker.

Epidemiology

Zenker diverticulum mainly affects older adults.

Mechanisms and manifestations

In simple words, when there is excessive pressure within the lower pharynx, the weakest portion of the pharyngeal wall balloons out, forming a diverticulum which may reach several centimetres in diameter.

More precisely, while traction and pulsion mechanisms have long been deemed the main factors promoting development of a Zenker's diverticulum, current consensus considers occlusive mechanisms to be most important: uncoordinated swallowing, impaired relaxation and spasm of the cricopharyngeus muscle lead to an increase in pressure within the distal pharynx, so that its wall herniates through the point of least resistance (variously known as Killian's triangle, Laimer's triangle, or more accurately Killian-Laimer triangular dehiscence). The result is an outpouching of the posterior pharyngeal wall, just above the oesophagus.[1]

While it may be asymptomatic, Zenker diverticulum often causes clinical manifestations such as dysphagia (difficulty swallowing), and sense of a lump in the neck; moreover, it may fill up with food, causing regurgitation (reappearance of ingested food in the mouth), cough (as some food may be regurgitated into the airways) and halitosis (smelly breath, as stagnant food is digested by microrganisms). It rarely causes any pain.

Diagnosis

A simple barium swallow will normally reveal the diverticulum. This may be coupled with esophagoscopy.


Barium swallow graphy: Zenker's diverticulum


Histopathological Findings: Esophagus; Zenker's diverticulum

<youtube v=CEYU0Dq9n2s/>

Treatment

If small and asymptomatic, no treatment is necessary. Larger, symptomatic cases of Zenker's diverticulum have been traditionally treated by neck surgery to resect the diverticulum and incise the cricopharyngeus muscle. However, in recent times non-surgical endoscopic techniques have gained more importance (as they allow for much faster recovery), and the currently preferred treatment is endoscopic stapling[2][3] (i.e. closing off the diverticulum via a stapler inserted through a tube in the mouth). This may be performed through a fibreoptic endoscope[4]. Other non-surgical treatment modalities exist, such as endoscopic laser, which recent evidence suggests it less effective than stapling.[5]

References

  1. PMID 12903677 Pathogenesis and methods of treatment of Zenker's diverticulum, Ann Otol Rhinol Laryngol. 2003 Jul;112(7):583-93
  2. PMID 15453934 Endoscopic stapling of pharyngeal pouch, J Laryngol Otol. 2004 Aug;118(8):601-6
  3. PMID 12782805 Endoscopic staple diverticulostomy for Zenker's diverticulum: review of literature and experience in 159 consecutive cases, Laryngoscope. 2003 Jun;113(6):957-65
  4. PMID 15966520 Fiberoptic endoscopic-assisted diverticulotomy: a novel technique for the management of Zenker's diverticulum, Ann Otol Rhinol Laryngol. 2005 May;114(5):347-51
  5. PMID 16954989 The Endoscopic Management of Zenker Diverticulum: CO2 Laser versus Endoscopic Stapling, Laryngoscope. 2006 Sep;116(9):1608-11

Other external links

Template:SIB Template:Gastroenterology de:Zenker-Divertikel it:Diverticolo di Zenker


Template:WikiDoc Sources