Pharyngeal (Zenker) Diverticulum
Mechanism: Spasm of cricopharyngeus muscle leads to herniation of pharyngeal mucosa through Killian’s Dehiscence; a triangle in the posterior pharyngeal wall bound by oblique fibers of inferior pharyngeal constrictor muscles and transverse fibers of cricopharyngeus muscle.
Regurgitation of non-digested food; especially on lying down.
Neck swelling: Soft, compressible and gets bigger after meals.
Complications: Perforation and malignancy.
Diagnosis: Barium swallow is the test of choice (Esophagogastroduodenoscopy “EDG” might cause perforation).
Small diverticulum: Repeated dilatation.
Large diverticulum: Diverticulopexy or diverti- culectomy.
Congenital Esophageal Atresia
Introduction: Usually associated with tracheo-esophageal fistula.
Types: Multiple; the most common is an esophagus with a blind upper pouch, and a lower pouch connected to the trachea.