Zenker’s diverticulum in an 85-year-old Ugandan man

Abstract

Background Zenker’s diverticulum (ZD) is an uncommon disorder due to an outpouching of tissue through the Killian triangle that is thought to be caused by dysfunction of the cricopharyngeal muscle. Case presentation An 85-year-old male patient presented with odynophagia and dysphagia of initially solid food followed by fluids that was associated with a significant weight loss over a one-year period. Barium swallow videofluoroscopy demonstrated a posterior outpouching of proximal esophagus that was 2 cm from the epiglottis. With the diagnosis of medium sized ZD, the patient underwent endoscopy guided diverticulotomy. Six months after the procedure, he was asymptomatic and had gained weight. Conclusions Dysphagia and weight loss raises a clinical suspicion for a malignancy. Barium swallow examination is an inexpensive method for the diagnosis of ZD.

Squamous cell carcinoma arising in a Zenker diverticulum

“…Barium swallow combined with continuous videofluoroscopy is the standard method for diagnosing ZD. This exam provides information about the size, shape and location of the diverticulum [ 7 ]. A transcutaneous ultrasound is an alternative method for patients with trouble swallowing or risk of aspiration [ 8 ].…”