Merck Manual

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Esophageal Diverticula


Kristle Lee Lynch

, MD, Perelman School of Medicine at The University of Pennsylvania

Reviewed/Revised Feb 2024
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An esophageal diverticulum is an outpouching of mucosa through the muscular layer of the esophagus. It can be asymptomatic or cause dysphagia Dysphagia Dysphagia is difficulty swallowing. The condition results from impeded transport of liquids, solids, or both from the pharynx to the stomach. Dysphagia should not be confused with globus sensation... read more and regurgitation. Diagnosis is made by barium swallow; surgical repair is rarely required.

Types of Diverticula

There are several types of esophageal diverticula, each of different origin:

Symptoms and Signs of Esophageal Diverticula

A Zenker diverticulum fills with food that might be regurgitated when the patient bends or lies down. Aspiration pneumonitis may result if regurgitation is nocturnal. Rarely, the pouch becomes large, causing dysphagia and sometimes a palpable neck mass.

Traction and epiphrenic diverticula are rarely symptomatic, although their underlying cause may be.

Diagnosis of Esophageal Diverticula

  • Barium swallow

All diverticula are diagnosed by videotaped barium swallow and often confirmed on upper endoscopy.

Treatment of Esophageal Diverticula

  • Usually none

  • Sometimes surgical resection

Specific treatment is usually not required, although resection is occasionally necessary for large or symptomatic diverticula.

Diverticula associated with motility disorders require treatment of the primary disorder. For example, case reports suggest doing a cricopharyngeal myotomy when resecting a Zenker diverticulum. There are also endoscopic treatment options for diverticulectomy.

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