Esophageal Diverticulum (Pulsion, Traction, Zenker’s)

An esophageal diverticulum is a pouch of mucous membrane that sticks out through the esophageal lining, in the case of repeated, hard swallowing against a blockage (pulsion diverticulum). Blockage can be caused by a motility disorder or stricture. A Zenker’s diverticulum results from the upper esophageal sphincter’s failure to relax. Less commonly, scarring next to the esophagus pulls the esophageal wall in the direction of the scarring (traction diverticulum), usually resulting from scarring of a healed, previously infected chest lymph node.

Cause

The cause is not always known. Esophageal diverticulum is more common in people with an esophageal motility disorder, such as achalasia.

Symptoms

  • Regurgitation of previously eaten food
  • Chest pain
  • Foul breath
  • Food getting “stuck”

Diagnosing Esophageal Diverticulum

  • Upper GI (gastrointestinal) series, also called a barium swallow: This test looks at the organs of the top part of the digestive system. After you swallow a metallic fluid called barium, which coats the organs so they can be seen on an X-ray, a provider checks the food pipe (esophagus), stomach and first part of the small intestine (duodenum).
  • Upper endoscopy or EGD (esophagogastroduodenoscopy): This test looks at the lining or inside of the esophagus, stomach and duodenum. The test is performed with an endoscope, a thin, lighted tube with a camera on the end. The endoscope is inserted into the mouth and throat. Then it goes into the esophagus, stomach and duodenum. 
  • CT scan

Treatments

A surgeon can treat the underlying motility disorder and remove the diverticulum. If the diverticulum is small enough, cutting the abnormally closed sphincter will often make the diverticulum to disappear.