Zenker’s Diverticulum

UPMC Content 3

Zenker’s diverticulum is a pouch that forms at the back of the throat where the voice box (pharynx) and esophagus meet. The protruding pouch causes swallowing issues.

The primary symptom is difficulty in swallowing food; sometimes food comes back up several minutes or hours after eating.

People also experience:

  • Choking feelings
  • A feeling of mucous collecting in the throat
  • Hoarse speech
  • Bad breath

Tests for Diagnosing Zenker’s Diverticulum

Experts don’t know exactly what causes Zenker’s diverticulum, but do know it’s associated with increased pressure in the esophagus. This pressure causes the esophageal mucous membrane to herniate through a defective wall in the esophagus.

Some people with the disorder have other issues with their esophagus, but not always.

Preoperative evaluation includes similar testing used for giant paraesophageal hernias.

  • Barium esophagography — provides an anatomic road for evaluation of the swallowing disorder.
  • Upper endoscopy — examines the esophageal mucosa and helps identify conditions that may mimic Zenker’s diverticulum.
  • Esophageal manometry — studies the pressure inside the esophagus.

Treating Zenker’s Diverticulum

UPMC thoracic surgeons perform both traditional and minimally invasive surgery for treating Zenker’s diverticulum.

Traditional surgery involves an open neck incision.

The minimally invasive technique uses a transoral (through-the-mouth) approach.

Compared to traditional open surgery, advantages to minimally invasive surgery for Zenker’s diverticulum include:

  • Shortened hospital stay
  • Quicker recovery time
  • Earlier return to swallowing and eating normally