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
✓ Usually a male and elderly. ✓ Gurgling sounds in the neck at the time of swallowing. ✓ Dysphagia., HalitosisZ ✓ Regurgitation of food after turning from one side to another ✓ leading to features of aspiration pneumonitis, lung abscess and mediastinitis ✓ The swelling is soft and cystic with audible gurgling. ✓ 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
