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Zenker’s or pharyngoesophageal diverticulum is the most common diverticulum of the esophagus. It is herniation of the esophageal mucosa and submucosa through a weak point in the muscle layers of the hypopharynx. The most common herniation site, known as Killian’s triangle, is bordered by the inferior constrictor muscle or thyropharyngeus superiorly, and by the cricopharyngeus muscle inferiorly. A Zenker’s diverticulum is a false or pseudodiverticulum, as its wall is not full thickness. Characteristic symptoms include dysphagia, spontaneous regurgitation of food, coughing, and episodic choking. Surgical intervention is indicated for symptoms and/or a large size (greater than 3 cm). Surgical treatment options include open cricopharyngeal myotomy with diverticulectomy or diverticulopexy and transoral endoscopic diverticulotomy.
Additional Resources
- Lerut T, Coosemans W, Decaluwé H, et al. Zenker’s Diverticulum. Multimed Man Cardiothorac Surg. 2009 Jan 1;2009(224):mmcts.2007.002881.
- Samson P, Puri V. Esophageal Diverticula. In: LoCicero J, Feins RH, Colson YL, Rocco G, eds. Shields’ General Thoracic Surgery. 8th ed. Philadelphia, PA: Wolters Kluwer; 2018:1826-1833.
