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For further information, see CMDT Part 15-19: Benign Esophageal Lesions

Key Features

  • Protrusion of pharyngeal mucosa develops at the pharyngoesophageal junction between the inferior pharyngeal constrictor and the cricopharyngeus

  • Loss of elasticity of the upper esophageal sphincter, resulting in restricted opening during swallowing, is believed to be the cause

Clinical Findings

  • Dysphagia and regurgitation tend to develop insidiously over years in older predominantly male patients

  • Initial symptoms include vague oropharyngeal dysphagia with coughing or throat discomfort

  • As the diverticulum enlarges and retains food, patients may note

    • Halitosis

    • Spontaneous regurgitation of undigested food

    • Nocturnal choking

    • Gurgling in the throat

    • Protrusion in the neck

  • Complications

    • Aspiration pneumonia

    • Bronchiectasis

    • Lung abscess

Diagnosis

  • Video esophagography is the best method to establish diagnosis

Treatment

  • Observation is sufficient for small asymptomatic diverticula

  • Upper esophageal myotomy is required for symptomatic patients

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