outpouching due to ?
Pharyngeal Pouch- Zenker’s Diverticulum
A laterally placed swelling of the neck located behind the sternomastoid muscle below the thyroid cartilage. It occurs as a result of protrusion or herniation of the mucosa of the pharyngeal wall through the Killian’s dehiscence.
The later is a weak area of the pharyngeal wall between the oblique fibres of thyropharyngeus and the sphincter like transverse fibres of cricopharyngeus part of the inferior constrictor muscle.
Clinical Features:Z
âś“ Usually a male and elderly. âś“ Gurgling sounds in the neck at the time of swallowing. âś“ Dysphagia., HalitosisZ âś“ Regurgitation of food after turning from one side to another âś“ leading to features of aspiration pneumonitis, lung abscess and mediastinitis âś“ The swelling is soft and cystic with audible gurgling. âś“ The contents may be emptied on pressure into the pharynx and mouth.
Investigation:
Thin Barium Swallow – Evidence of pouch
Esophagoscopy - not indicated - may result in perforation
finding
outpouching
Diagnosis
Zenker’s Diverticulum
Treatment
Excision of the pouch
