Esophageal diverticulum

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Esophageal diverticulum

 Zenker's Diverticulum : 

• Male predominance , > 50 years

• If enlarges then usually goes to left side.

• MC presentation : Dysphagia (Intermittent)

• Earliest presentation : Regurgitation (Also with Achlasia and GERD )

Note :
In Achlasia and Zenker - Old food regurgitates
In GERD - Fresh food regurgitates.

Sign : Swelling , changing size , gurgling sound - Boyce's Sign (Actual it is for laryngocele)

Investigation of choice : Barium swallow.

Treatment :

1. Diverticulectomy + Cricopharyngomyotomy
2. Botulinum toxin in cricopharynx (its temporary)
3. Diverticulopexy
4. Dohlman's procedure
5. Medical : DOC - Calcium channel block - Nifedipine.

Causes of Intermittent Dysphagia :

1. Zenker's diverticulum
2. Eosinophilic esophagitis.
3. Diffuse esophageal spasm

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