Zenker's diverticulum is usually only treated if it causes significant symptoms, and surgery is the primary mode of treatment. If there are no symptoms, your doctor may recommend waiting until symptoms appear.
The goal of the surgery is to relieve obstruction caused by the diverticulum sac There are two types of surgical options:
- Open surgery: Involves making an incision over the neck and reaching in to remove the sac from the esophageal wall. This is the surgery of choice when the diverticulum is large and cannot be removed by endoscopy.
- Endoscopic approach: Less invasive procedure that uses either rigid or flexible endoscopes. This approach involves cutting into the wall that separates the diverticulum sac from the esophagus, allowing food that goes into the sac to be redirected to the esophagus.
What is Zenker's diverticulum?
A diverticulum is an abnormal pouch-like structure that forms in all parts of the digestive tract. Zenker's diverticulum occurs when the pouch forms at the junction of the pharynx (upper throat) and the esophagus. It is a rare condition affecting between 0.01% and 0.11% of the population.
Zenker's diverticulum is more common in:
- Middle-aged and older adults, especially those between ages 70 to 80
- Men (less common in women)
How is Zenker's diverticulum managed?
When it comes to managing Zenker's diverticulum, it’s important to consider the following:
- There is a less than 4% chance of Zenker's diverticulum returning after surgery.
- Even if you have no symptoms, it’s best to eat soft foods that can be easily chewed and swallowed.
- Call your doctor if you experience the following symptoms:
- Shortness of breath
- Difficulty swallowing
- Food getting stuck after swallowing
- Avoid foods that can lead to retention of food in the esophagus:
Talk to your doctor if you need a referral to a gastroenterologist or surgeon.
What are the complications of Zenker's diverticulum?
If left untreated, Zenker's diverticulum can grow and cause complications such as:
- Difficulty swallowing
- Aspiration pneumonia (an infection that occurs when food, saliva, or other matter gets trapped in the lungs)
- Esophageal obstruction
- Vocal cord paralysis
- Squamous cell carcinoma
- Fistulas (an abnormal opening in the digestive tract, leading to leakage of gastric content)
Complications of open surgery may include:
- Nerve damage
- Fistula formation
- Mediastinitis (swelling and inflammation of the chest area between the lungs)
Complications of endoscopy include:
- Dental injury
- Esophageal perforation
- Cervical emphysema (air is trapped in the lower layers of the skin)
Health Solutions From Our Sponsors
Schiff B, van Delft F. Zenker's Diverticulum. UpToDate. https://www.uptodate.com/contents/zenkers-diverticulum
Columbia University. Zenker’s Diverticulum. https://www.entcolumbia.org/content/zenker-s-diverticulum
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