Zenker's diverticulum: Difference between revisions

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'''For patient information, click [[Zenker's diverticulum (patient information)|here]]'''
'''For patient information, click [[Zenker's diverticulum (patient information)|here]]'''


{{CMG}}
{{CMG}} [[Associate editor-In-Chief|'''Associate editor-In-Chief''']]:{{Ajay}}


{{SK}} Hypopharyngeal diverticulum, pharyngoesophageal diverticulum, pharyngeal pouch.
{{SK}} Hypopharyngeal diverticulum, pharyngoesophageal diverticulum


==[[Zenker's diverticulum overview|Overview]]==
==[[Zenker's diverticulum overview|Overview]]==
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==[[Zenker's diverticulum differential diagnosis|Differentiating Zenker's diverticulum from other Diseases]]==
==[[Zenker's diverticulum differential diagnosis|Differentiating Zenker's diverticulum from other Diseases]]==
{| class="wikitable"
!Disease
!Signs & Symptoms
!Findings on barium swallow
!Endoscopy
!Imaging test
|-
|Reflux esophagitis
|Dysphagia (from peptic stricture)
Heartburn
Hoarseness
|
* Poor clearance
* Free reflux of barium
|
* peptic stricture (advanced cases)
|A hiatus hernia may be present below the stricture
Lower esophageal pH studies will demonstrate pathologic gastroesophageal reflux
|-
|Esophageal carcinoma
|Dysphagia (initially for solids, liquids develops with advanced disease.)
Weight loss
Lymphadenopathy
Appetite changes
Cachexia
|
* irregular stricture
* pre-stricture dilatation
|
* Most accurate test for diagnosis
* esophageal obstruction
* staging of disease
|Biopsy: for definite diagnosis and tumor histology
|-
|Systemic sclerosis
|Dysphagia
Muscle and joint pain
Raynaud's phenomenon
skin changes (e.g., rash, skin swelling or thickening).
|
* Dysmotility
* Patulous esophagus
|Mucosal damage
Peptic stricture (advanced cases)
|Serology for
Antinuclear antibodies
Rheumatoid factor
creatine kinase
ESR
|-
|Esophageal spasm
|Chest pain (more prominent)
Dysphagia (intermittent)
|
* Corkscrew or
rosary bead esophagus
* nonperistaltic contractions
|Inconclusive
|Manometry:  high-amplitude esophageal contractions
|-
|Pseudoachalasia
|Dysphagia
Weight loss
Lymphadenopathy
Appetite changes
Cachexia
Older patients
Underlying malignancy that mimics idiopathic achalasia.
Patients tend to be older, duration of symptoms shorter, and weight loss greater and more rapid.
|
* More marked mucosal irregularity
* Temporary patency of LES
|
* Most accurate test for diagnosis
* esophageal obstruction
* staging of disease
|Gastroscopic biopsy of gastroesophageal junction and cardia may demonstrate malignancy.
Findings at endoscopy, barium swallow, and manometry may be indistinguishable from achalasia.
|-
|Chagas disease
|Dysphagia
myocarditis
Blepharitis
Toxic megacolon
|
* oesophageal dilatation
* stasis of barium
|
*  dilated esophagus
* thickened LES (muscular ring)
|Giemsa stain: ''Trypanosoma cruzi''.
PCR for trypanosome subtype
|-
|Pharyngitis
|Dysphagia
Fever
Throat pain
|Normal
|Inconclusive
|erythema, edema and/or exudates of the pharynx; tonsillar hypertrophy may cause severe narrowing of the pharynx; lymphadenopathy of the neck is often present
|-
|Esophageal candidiasis
|Dysphagia
Immunocompromised
History of corticosteroid
|
* shaggy" appearance (plaques)
* irregular contours in the lower third
|
* ulceration 
* plaques and pseudomembranes
* tiny nodules, polypoid folds (advanced cases)
|creamy white or yellowish plaques (thrush) in oropharynx or hypopharynx; may be normal exam
|-
|Stroke
|progressive Dysphagia; 
dysarthria;
limb weakness
Fatigue
|
* pooling of contrast in the pharynx 
* aspiration of the barium contrast into the airway.
|
* reduced opening of upper esophageal sphincter
* reduced larynx elevation
|paraplegia, aphasia, dysarthria, vertigo, staggering, diplopia, deafness
|}


==[[Zenker's diverticulum epidemiology and demographics|Epidemiology and Demographics]]==
==[[Zenker's diverticulum epidemiology and demographics|Epidemiology and Demographics]]==
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==Treatment==
==Treatment==
[[Zenker's diverticulum medical therapy|Medical Therapy]] | [[Zenker's diverticulum surgery|Surgery]] | [[Zenker's diverticulum primary prevention|Primary Prevention]]  | [[Zenker's diverticulum secondary prevention|Secondary Prevention]] | [[Zenker's diverticulum cost-effectiveness of therapy|Cost-Effectiveness of Therapy]] | [[Zenker's diverticulum future or investigational therapies|Future or Investigational Therapies]]
[[Zenker's diverticulum medical therapy|Medical Therapy]] | [[Zenker's diverticulum surgery|Surgery]] | [[Zenker's diverticulum primary prevention|Primary Prevention]]  | [[Zenker's diverticulum cost-effectiveness of therapy|Cost-Effectiveness of Therapy]] | [[Zenker's diverticulum future or investigational therapies|Future or Investigational Therapies]]


==Case Studies==
==Case Studies==
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Latest revision as of 14:21, 3 January 2018

Zenker's diverticulum
Source:Radiopaedia[1]
ICD-10 K22.5
ICD-9 530.6
DiseasesDB 31174
MeSH D016672

Zenker's diverticulum Microchapters

Home

Patient Information

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Zenker's diverticulum from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

History and Symptoms

Physical Examination

Laboratory Findings

Electrocardiogram

X Ray

CT

MRI

Ultrasound

Other Imaging Findings

Other Diagnostic Studies

Treatment

Medical Therapy

Surgery

Primary Prevention

Secondary Prevention

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Case Studies

Case #1

Zenker's diverticulum On the Web

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MRI

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FDA on Zenker's diverticulum

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Zenker's diverticulum in the news

Blogs on Zenker's diverticulum

Directions to Hospitals Treating Zenker's diverticulum

Risk calculators and risk factors for Zenker's diverticulum

For patient information, click here

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate editor-In-Chief: Ajay Gade MD[2]]

Synonyms and keywords: Hypopharyngeal diverticulum, pharyngoesophageal diverticulum

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Zenker's diverticulum from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

History and Symptoms | Physical Examination | Laboratory Findings | Electrocardiogram | X Ray | CT | MRI | Ultrasound | Other Imaging Findings | Other Diagnostic Studies

Treatment

Medical Therapy | Surgery | Primary Prevention | Cost-Effectiveness of Therapy | Future or Investigational Therapies

Case Studies

Case #1

Template:Gastroenterology de:Zenker-Divertikel it:Diverticolo di Zenker


Template:WikiDoc Sources

  1. ↑ "Zenker diverticulum | Radiology Case | Radiopaedia.org".
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