Zenker's diverticulum
Zenker's diverticulum Source:Radiopaedia[1] | |
ICD-10 | K22.5 |
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ICD-9 | 530.6 |
DiseasesDB | 31174 |
MeSH | D016672 |
Zenker's diverticulum Microchapters |
Diagnosis |
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Treatment |
Case Studies |
Zenker's diverticulum On the Web |
American Roentgen Ray Society Images of Zenker's diverticulum |
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Synonyms and keywords: Hypopharyngeal diverticulum, pharyngoesophageal diverticulum, pharyngeal pouch.
Overview
Historical Perspective
Classification
Pathophysiology
Causes
Differentiating Zenker's diverticulum from other Diseases
Disease | Signs & Symptoms | Findings on barium swallow | Endoscopy | Imaging test |
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Reflux esophagitis | Dysphagia (from peptic stricture)
Heartburn Hoarseness |
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A hiatus hernia may be present below the stricture
Lower esophageal pH studies will demonstrate pathologic gastroesophageal reflux |
Esophageal carcinoma | Dysphagia (initially for solids, liquids develops with advanced disease.)
Weight loss Lymphadenopathy Appetite changes Cachexia |
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Biopsy: for definite diagnosis and tumor histology |
Systemic sclerosis | Dysphagia
Muscle and joint pain Raynaud's phenomenon skin changes (e.g., rash, skin swelling or thickening). |
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Mucosal damage
Peptic stricture (advanced cases) |
Serology for
Antinuclear antibodies Rheumatoid factor creatine kinase ESR |
Esophageal spasm | Chest pain (more prominent)
Dysphagia (intermittent) |
rosary bead esophagus
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Inconclusive | Manometry: high-amplitude esophageal contractions |
Pseudoachalasia | Dysphagia
Weight loss Lymphadenopathy Appetite changes Cachexia Older patients Underlying malignancy that mimics idiopathic achalasia. Patients tend to be older, duration of symptoms shorter, and weight loss greater and more rapid. |
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Gastroscopic biopsy of gastroesophageal junction and cardia may demonstrate malignancy.
Findings at endoscopy, barium swallow, and manometry may be indistinguishable from achalasia. |
Chagas disease | Dysphagia
myocarditis Blepharitis Toxic megacolon |
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Giemsa stain: Trypanosoma cruzi.
PCR for trypanosome subtype |
Pharyngitis | Dysphagia
Fever Throat pain |
Normal | Inconclusive | erythema, edema and/or exudates of the pharynx; tonsillar hypertrophy may cause severe narrowing of the pharynx; lymphadenopathy of the neck is often present |
Esophageal candidiasis | Dysphagia
Immunocompromised History of corticosteroid |
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creamy white or yellowish plaques (thrush) in oropharynx or hypopharynx; may be normal exam |
Stroke | progressive Dysphagia;
dysarthria; limb weakness Fatigue |
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paraplegia, aphasia, dysarthria, vertigo, staggering, diplopia, deafness |
Epidemiology and Demographics
Risk Factors
Screening
Natural History, Complications and Prognosis
Diagnosis
History and Symptoms | Physical Examination | Laboratory Findings | Electrocardiogram | X Ray | CT | MRI | Ultrasound | Other Imaging Findings | Other Diagnostic Studies
Treatment
Medical Therapy | Surgery | Primary Prevention | Secondary Prevention | Cost-Effectiveness of Therapy | Future or Investigational Therapies
Case Studies
Template:Gastroenterology de:Zenker-Divertikel it:Diverticolo di Zenker