Related Experiment Video

Updated: Apr 28, 2026

Laparoscopic Splenectomy with Pericardial Devascularization for Hypersplenism and Esophageal Variceal Hemorrhage Due to Portal Hypertension
04:00

Laparoscopic Splenectomy with Pericardial Devascularization for Hypersplenism and Esophageal Variceal Hemorrhage Due to Portal Hypertension

Published on: November 15, 2024

1.1K

Where's the ulcer? Spontaneous bleeding from Zenker's diverticulum

Nitin Sardana1, Dustin Wallace1, Radheshyam Agrawal1

  • 1Division of Gastroenterology, Allegheny Health Network, Pittsburgh, Pennsylvania, USA.

BMJ Case Reports
|June 12, 2014
PubMed

Insights

This case study highlights a rare cause of severe upper gastrointestinal bleeding: Zenker's diverticulum. Prompt management, including INR reversal and packed red blood cells, successfully treated the patient's life-threatening hemoptysis.

Area of Science:

  • Gastroenterology
  • Surgical Gastroenterology

Background:

  • Zenker's diverticulum is a rare outpouching of the pharyngeal mucosa.
  • It can present with diverse symptoms, including dysphagia and upper gastrointestinal bleeding.

Observation:

  • An 89-year-old male presented with hemoptysis and a history of dysphagia.
  • He was hypotensive with significant anemia and an elevated International Normalized Ratio (INR).
  • Esophagogastroduodenoscopy revealed active bleeding from Zenker's diverticulum.

Findings:

  • Bleeding was controlled after reversing the patient's INR with fresh frozen plasma and administering packed red blood cells.
  • A barium swallow confirmed a large Zenker's diverticulum (9 cm).
  • The patient underwent successful diverticulectomy and cricopharyngeal myotomy.

Implications:

  • Zenker's diverticulum should be considered in the differential diagnosis of upper gastrointestinal bleeding, especially in elderly patients with dysphagia.
  • Timely diagnosis and management, including surgical intervention, are crucial for favorable outcomes.
  • This case underscores the importance of comprehensive diagnostic evaluation for unexplained bleeding.

More Related Videos

Author Spotlight: Advancing Spectral Characterization of Physiological and Malperfused Tissues04:57

Author Spotlight: Advancing Spectral Characterization of Physiological and Malperfused Tissues

Published on: July 5, 2024

941
Endoscopic Vacuum Therapy for the Treatment of Anastomotic Leakage after Total Gastrectomy with Esophagojejunostomy04:05

Endoscopic Vacuum Therapy for the Treatment of Anastomotic Leakage after Total Gastrectomy with Esophagojejunostomy

Published on: August 22, 2025

1.2K

Related Concept Videos

Esophageal Varices-I: Introduction01:24

Esophageal Varices-I: Introduction

Esophageal varices are dilated, tortuous veins which are found mainly in the submucosa of the lower esophagus but which may also appear higher up or extend into the stomach. They develop due to increased pressure in the portal venous system, often as a result of liver cirrhosis. This condition scars and damages the liver, impeding normal blood flow through the portal vein. To compensate, blood seeks alternative pathways, forming fragile new vessels (varices) in the esophagus and stomach. These...
2.4K
Diverticular Disease of the Colon01:27

Diverticular Disease of the Colon

Diverticular disease involves the formation of diverticula—small sac-like outpouchings of the colonic wall—and their complications. It most commonly affects the sigmoid colon due to higher intraluminal pressure and structural vulnerability. It results from structural weakness and increased pressure in the colon, producing pseudodiverticula that may remain silent or progress to inflammation and serious complications.Structure of DiverticulaIn diverticulosis, these outpouchings are...
31
Esophageal Varices-II: Clinical Features and Management01:28

Esophageal Varices-II: Clinical Features and Management

Esophageal varices often manifest as gastrointestinal bleeding episodes, presenting symptoms like hematemesis (vomiting of blood), hematochezia (passing fresh blood via the rectum), and melena (black, tarry stools). Other signs can include weight loss, anorexia, abdominal discomfort, jaundice, pruritus, altered mental status, and muscle cramps.
In the initial assessment, a thorough review of the patient's medical history is vital to identify risk factors such as liver disease, alcohol...
882
Esophageal Perforation-I: Introduction01:22

Esophageal Perforation-I: Introduction

Esophageal perforation is a severe medical condition characterized by a breach in the integrity of the esophageal wall. This breach can occur due to various factors such as trauma, medical procedures, or underlying diseases. When the esophageal wall is compromised, it allows food, fluids, and digestive juices into the chest cavity or adjacent structures, leading to potential complications and health risks.
The location of esophageal perforation can vary, occurring anywhere along the esophagus....
842
Disorders of Hemostasis01:24

Disorders of Hemostasis

Hemostasis, the process that stops bleeding after a blood vessel injury, is crucial for maintaining the integrity of the circulatory system. However, disorders of hemostasis can disrupt this delicate balance, leading to either excessive clotting or bleeding. These disorders can be broadly classified into thromboembolic disorders and bleeding disorders.
Thromboembolic Disorders
Two factors primarily cause thromboembolic conditions.
2.7K
Esophageal Perforation-II: Clinical Manifestations and Management01:28

Esophageal Perforation-II: Clinical Manifestations and Management

Esophageal perforations manifest in various clinical forms, influenced by factors such as the perforation's cause and location (cervical, intrathoracic, or intra-abdominal), the extent of contamination, and potential injury to adjacent mediastinal structures. The timing between the perforation occurrence and treatment initiation also affects the clinical presentation.
Clinical Manifestations:
1.1K