Esophageal Diverticula

Diverticula are bulges in the esophageal wall that are usually secondary to motility issues; we use barium swallow to diagnose. Esophageal Diverticula See below for image credits. Zenker diverticula are the most common type; these form when the upper esophageal sphincter (aka, cricopharyngeal muscle) doesn't relax and intraluminal pressure is increased. They occur in the upper 1/3 of the esophagus, producing dysphagia with regurgitation, halitosis (bad smelling breath), and chronic cough. Note that regurgitated food may be from several days ago. Traction diverticula (aka, midesophageal diverticula) are secondary lesions caused by external forces. They are usually the result of mediastinal inflammation, often from tuberculosis, that pulls on the esophageal wall and creates a true diverticulum. Epiphrenic diverticula occur in the distal 1/3 esophagus; these are usually the result of motility disorders.