Zenker Diverticulum

Aka: Zenker Diverticulum, Esophagopharyngeal Diverticulum, Zenkers Diverticulum

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II. Epidemiology

  1. Age: 70-80 years
  2. Gender: Male predominance
  3. Incidence: 0.01–0.11% (U.S.)

III. Background

  1. First described by Abraham Ludlow (1679)
  2. Named for german pathologist Friedrich Albert von Zenker (1877)

IV. Pathophysiology

  1. Esophageal mucosa and submucosa outpouching
    1. Diverticulum protrudes through the posterior esophageal wall
    2. Passes between the thyropharyngeus and cricopharyngeus Muscles
  2. Diverticulum caused by increased hypopharyngeal pressure
    1. May result from incomplete opening of the upper esophageal sphincter

V. Findings

  1. Dysphagia
  2. Regurgitation of undigested food
  3. Halitosis

VI. Complications

  1. Chronic Cough
  2. Aspiration Pneumonitis
  3. Unintentional Weight Loss

VII. Imaging

  1. Barium Swallow (preferred)
  2. Ultrasound

VIII. Differential Diagnosis

  1. See Esophageal Dysphagia

IX. Management

  1. Indications for Diverticulum correction by Endoscopic surgery
    1. Symptomatic patients with Diverticulum >1 cm

X. Resources

  1. Zenker Diverticulum (StatPearls)
    1. https://www.ncbi.nlm.nih.gov/books/NBK499996/

XI. References

  1. Kalra (2025) Am Fam Physician 112(2): 205-6 [PubMed]
  2. Nehring (2013) Prz Gastroenterol 8(5):284-9 +PMID: 24868270 [PubMed]

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