gastrointestinal disorders
Esophageal Diverticula
Introduction
An esophageal diverticulum is an outpouching of mucosa through the muscular layer of the esophagus. It can be asymptomatic or cause Dysphagia and regurgitation. Diagnosis is made by barium swallow; surgical repair is rarely required. (See also Overview of Esophageal and Swallowing Disorders .) Small diverticula in the upper esophagus were noted incidentally in this patient during an evaluation for nausea and vomiting. Image provided by David M. Martin, MD. Zenker diverticula are posterior outpouchings of mucosa and submucosa through the cricopharyngeal muscle. In this image, the diverticulum is on the left, next to the triangular opening of the trachea formed by the vocal cords. Image provided by David M. Martin, MD. Traction diverticula are midesophageal outpouchings of mucosa and submucosa caused by motility disorders or by traction resulting from mediastinal processes. In this image, the diverticulum is to the right of the esophagus and gives the appearance of a double lumen. Image provided by David M. Martin, MD. There are several types of esophageal diverticula, each of different origin: Zenker (pharyngeal) diverticula are posterior outpouchings of mucosa and submucosa through the cricopharyngeal muscle, probably resulting from an incoordination between pharyngeal propulsion and cricopharyngeal relaxation. Midesophageal (traction) diverticula are caused by traction resulting from mediastinal inflammatory lesions or, secondarily, by Esophageal Motility Disorders . Epiphrenic diverticula occur just above the diaphragm and usually accompany a motility disorder (eg, Achalasia , 