Outpatient basis by monitoring their symptoms. Patients with minimal symptomatology who do not desire surgical therapy may be followed up on a routine Loss and recurrent pulmonary infections occur in approximately one-third of the patients. Some patients also report excessive salivation and the sensation of a mass within the throat. Symptoms include halitosis, regurgitation of undigested food, noisy swallowing, and aspiration. The most common presenting feature is upper esophageal dysphagia, which occurs in as many as 98% of patients. Increased intrabolus pressure in patients with Zenker's diverticulum. No mechanism of pathogenesis has been generally accepted as yet, although the most recent have studies confirmed that there is an It is located between the obliquely oriented fibers of the thyropharyngeal muscleĪnd the horizontally oriented fibers of the cricopharyngeal muscle. The Zenker diverticulum occurs atĪn area of potential weakness in the inferior pharyngeal constrictor muscle referred to as the Killian dehiscence. Zenker's diverticulum is a pseudodiverticulum consisting of mucosa and submucosa that arise from the posterior portion of the inferior pharyngeal constrictor muscle. TheĮsophagus was displaced anteriorly by the diverticulum which was located between the esophageal-tracheal axis and the spine. All the swallowed barium was trapped into the diverticulum without there being a normal transit to the esophagus which was only evident when the diverticulum was full (Fig. The radiological diagnosis suggested that the patient had a pharyngoesophageal diverticulum (Zenker´sĭiverticulum). After swallowing barium, there appeared a large esophageal outpouchingĪrising from the midline of the posterior wall of the pharyngoesophageal junction. Based upon these findings, a barium esophageal examination was recommended. Was no evidence of a lower mediastinum widening. A large fluid level was observed from the midline at the upper mediastinum above the aortic arch there Physical examination done were found to be normal. He had no history of tobacco or alcohol use. These symptoms developed during a 15-month period. He also had an unintentional weight loss of 20 kg. A 50-year-old man, who was previously healthy, was discharged by our gastroenterologist with symptoms that included progressive intermittent but severe dysphagia, halitosis, paroxysms of coughing and
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