| Zenkerīs diverticula |
Zenkerīs diverticula with bezoar |
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The
left picture shows a Zenkerīs diverticula. It is
located at the dorsoesophageal
wall and is a pseudodiverticula, because it is formed
only by mucosa and
submucosa. Neurological coordination disorders of the
upper esophagus and
anatomical aspects are discussed as causative.
Symptoms at first are a mere
global sensation. Progression is frequent and leads to
esophageal compression
and dysphagia. Large diverticula can retain food
giving rise to the development
of a bezoar. Retained food can also result in
regurgitation, thus facilitating aspiration. The right picture shows a Zenkerīs
diverticula with a bezoar.
The endoscopist is always in danger causing a
diverticular perforation when
inserting the endoscope, resulting in a life-
threatening mediastinitis.
Apart from Zenkerīs diverticula at the upper entrance
of the esophagus, which is
ofcourse a pseudodiverticula, there is a second kind
called thoracal diverticula.
All those are true diverticula formed by all
anatomical layers of the esophageal
wall. Causes are suspected motility disorders,
inflammatory changes or genetic
abnormalities.
A third kind are the epiphrenic divertcula, also true
in anatomical nature. They
occur above the esophageal hiatus at the dorsal wall. |
