CLINICIAN zenker's diverticulum B

Indications: all patients with middle or lower esophageal diverticula, even if asymptomatic
OPTIONS EXPAND ALL
Findings: evidence of an underlying motility disorder
Esophageal diverticula Treatment
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Treatment

Surgical treatment is indicated for patients with symptomatic esophageal diverticula and can be considered for asymptomatic diverticula
≥ 2 cm. [2]

Zenker diverticulum [8]

Approaches
Open surgery: suitable for all patients who can tolerate general anesthesia
Flexible endoscopy: Consider for medium-sized diverticula (e.g., 2–5 cm). [2]
Rigid endoscopy: may not be possible in older patients with restricted neck mobility
Procedures: based on diverticulum size and the chosen approach (i.e., endoscopy or open surgery)
Cricopharyngeal myotomy: incision of the cricopharyngeal muscle (the main component of the upper esophageal sphincter) to relieve
[2]
esophageal obstruction; indicated for most patients
Diverticulotomy: division of the septum that separates a diverticulum from the physiological esophageal lumen
[2]
Diverticulectomy: resection of a diverticulum
Diverticulopexy: suspension of a diverticulum onto the hypopharyngeal wall
Diverticular inversion
Other options include stapling, electrocautery, or CO2 laser treatment.
Goal: to reduce pressure in the upper esophageal sphincter by removing or isolating the diverticulum

[2]
Other diverticula

Symptomatic or diverticulum ≥ 2 cm: Consider surgical intervention (e.g., diverticulopexy).

Asymptomatic
Treat any presumed underlying cause (e.g., esophageal motility disorders).
Employ expectant management.

Middle and distal esophageal diverticula are usually small and asymptomatic. Focus treatment on associated underlying
conditions. [2]

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Complications