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