A Surgically Treated Case of Pharyngoesophageal (Zenker's) Diverticulum

Hiroyuki Kawamura, Makoto Kataoka, Yoshiyuki Kuwabara, Yasuyuki Kureyama, Hiroshi Iwata, Noriyuki Shinoda, Taketoshi Kashima, Atsushi Satou, Kouji Hattori, Kouichirou Nakano, Akira Masaoka

Second Department of Surgery, Nagoya City University Medical School

Zenker's diverticulum is a relatively rare disease in Japan. We recently encountered a patient with this condition, which was treated surgically. A 59-year-old woman consulted a local clinic with a chief complaint of pain in the left side of the neck. At that clinic, esophageal fluoroscopy revealed a pool of the contrast material, which was located on the left side of the pharyngeal segment of the esophagus and which was equivalent in size of the index finger. Based on this finding, she was diagnosed as having Zenker's diverticulum and referred to our department. In our department, esophageal endoscopy disclosed the entrance to the diverticulum about 17 cm distant from the incisors. Computed tomography revealed a mass in contact with the pharyngeal segment of the esophagus. We diagnosed this patient as having Zenker's diverticulum, accompanied by diverticulitis. The woman underwent diverticulectomy in our department, during surgery, the diverticulum was slightly edematous and was found to have been formed from the Lannier-Hackerman's spatium. Histopathological examination allowed a diagnosis of diverticulitis, accompanied by inflammatory cell infiltration. Postoperative esophageal fluoroscopy revealed good passage of the contrast material and the diverticulum has not recurred. The postoperative course was uneventful, and the patient was discharged on the 9th hospital day. Surgical results of Zenker's diverticulum are usually good. Therefore, in cases where this condition is accompanied by diverticulitis or symptoms, as seen in the present case, it is recommended that this disease be treated surgically.

Key words
Zenker's diverticulum, pharyngoesophageal diverticulum

Reprint requests
Hiroyuki Kawamura Second Department of Surgery, Nagoya City University Medical School
Kawasumi 1, Mizuho-cho, Mizuho-ku, Nagoya, 467 JAPAN

Accepted
March 3, 1993

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