Zenker's diverticulum (hypopharyngeal pouch) is a rare medical entity caused by herniation of esophageal mucosa and submucosa through an anatomical defect between the layers of the inferior constrictor muscle. It is believed that this occurs mainly due to incoordination between the stages of swallowing and timely opening of the cricopharyngeus. It usually affects the elderly and patients usually present with dysphagia, regurgitation of food, halitosis and aspiration. We describe one case of Zenker's diverticulum in a 75-year Saudi female whom we successfully managed in Ear Nose Throat (ENT) department, North West Armed Forces Hospital, Tabuk, Saudi Arabia by endoscopic staple-assisted diverticulotomy resulting in successful division of the intervening septum between the diverticulum and the esophagus. This technique was well-tolerated by the patient with early return to oral feeding and shorter hospital stay. Endoscopic staple-assisted diverticulotomy is a relatively safer technique of dealing with this problem as compared to the traditional open procedure causing more morbidity, and we advocate its use to reduce patient morbidity in selected cases.
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Int J Surg Case Rep
January 2025
Department of Thoracic Surgery, Damascus Hospital,Damascus, Syria.
Introduction And Significance: Zenker's diverticulum is a rare condition characterized by a false diverticulum, as a true diverticulum involves herniation of all wall layers outward. Dysphagia, difficulty in swallowing, is the most common symptom. Diagnosis is primarily made through X-ray studies using contrast material during swallowing.
View Article and Find Full Text PDFCureus
December 2024
Medical Speciality Department, Niger Maradi Reference Hospital, Maradi, NER.
A Zenker's diverticulum (ZD) is an acquired hernia of the mucosa and submucosa at the pharyngoesophageal junction dorsally through Killian's triangle, considered a zone of weakness. The authors report their experience in the management of a case of a ZD with oral externalization following coughing. Surgery made by a multidisciplinary team consisted first of resection of the edematous exteriorized portion of the diverticulum.
View Article and Find Full Text PDFAnn Gastroenterol
December 2024
Center for Interventional Endoscopy (CIE), Advent Health, Orlando, FL, USA (Saurabh Chandan, Dennis Yang).
Background: Endoscopic treatments of symptomatic Zenker's diverticulum (ZD) include flexible endoscopic septotomy (FES) and, more recently, peroral endoscopic myotomy (Z-POEM). Data comparing these techniques are limited. We conducted a meta-analysis evaluating FES vs.
View Article and Find Full Text PDFJ Clin Gastroenterol
February 2025
Digestive Disease and Surgery Institute, Cleveland Clinic London, UK.
Peroral endoscopic myotomy (POEM) is a novel technique within the field of third space endoscopy. The overarching principal is creation of a mucosal incision, careful dissection of the submucosal space using an electrosurgical knife to reach the muscularis (ie, tunneling), performing a controlled myotomy, and finally, closure of the mucosal incision. POEM was first developed for the management of achalasia, and now a decade of evidence shows the procedure is safe, effective, and highly reproducible.
View Article and Find Full Text PDFOtolaryngol Head Neck Surg
January 2025
Department of Otolaryngology-Head and Neck Surgery, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA.
Objective: We aim to explore the differences in complication rates in endoscopic versus open transcervical treatment of Zenker diverticulum.
Study Design: Retrospective Cohort Study from January 1, 2015 to December 31, 2023.
Setting: Queries of the TriNetX database's United States Collaborative Network.
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