Zenker's diverticulum natural history, complications and prognosis

Zenker's diverticulum Microchapters
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief:

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Natural History

• Symptoms of Zenker's diverticulum slowly start as a
  • Progressive oropharyngeal dysphagia solids to liquids
  • Regurgitation of undigested food debris from the diverticulum
  • Pharyngeal stasis of secretion
  • Chronic cough
  • Chronic aspiration
  • Halitosis
  • Sensation of a lump in the throat
  • Hoarseness
  • Cervical borborygmi.

• The patient may note food on the pillow upon awakening in the morning.
• Although small diverticula may not cause symptoms, larger diverticula usually are symptomatic.
• Both the inability of the sphincter to fully open and the extrinsic compression from the pouch itself are likely to explain the dysphagia experienced by patients. * *In patients with very large diverticula, a gurgling swelling in the neck can occasionally be detected on palpation.

Complications

• Complications of the Zenker's diverticulum includes
• Aspiration pneumonia
• Bleeding of the diverticulum
• Ulceration of the diverticulum
• Compression of the trachea and esophageal obstruction with large diverticula
• Varey rarely Squamous cell carcinoma of the diverticulum
• Perforation of the diverticulum during the endoscopy and hence scopes with side viewing should be used to prevent perforation.