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Zenker's diverticulitis: a bitter pill to swallow
R J O'Neill1, E F Cleere1, N Elsafty1
1Beaumont Hospital, Dublin, Ireland.
Journal of Surgical Case Reports
|July 5, 2022
Summary
Zenker's diverticulum (ZD) can cause acute esophageal obstruction, even from small impacted items like an ibuprofen tablet. This case highlights ZD as an uncommon cause of complete esophageal blockage, potentially mimicking malignancy.
Area of Science:
- Gastroenterology
- Otolaryngology
- Digestive System Diseases
Background:
- Acute esophageal obstruction is frequently linked to underlying benign or malignant esophageal conditions.
- Zenker's diverticulum (ZD) is a common benign condition that can cause chronic dysphagia or be asymptomatic.
Observation:
- An 81-year-old male presented with complete esophageal obstruction due to an impacted ibuprofen tablet within a previously undiagnosed 1-cm Zenker's diverticulum.
- Initial investigations, including endoscopy and CT, were equivocal, suggesting potential upper esophageal malignancy.
Findings:
- Symptoms rapidly improved with systemic corticosteroid treatment, leading to a rapid differential diagnosis.
- Barium swallow confirmed the Zenker's diverticulum diagnosis, with no other abnormalities found.
Implications:
- Zenker's diverticulum is an uncommon but significant cause of acute esophageal obstruction, irrespective of diverticulum size.
- While conservative management may resolve acute episodes, surgical intervention is recommended for recurrent symptoms or large diverticula.
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