Atlas of Gastroenterological Endoscopy
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Zenkerīs diverticula Zenkerīs diverticula with bezoar
Zenkerīs Diverticula Zenkerīs Diverticula
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.