Zenker's Diverticulum

Zenker's diverticulum, which manifests itself with swallowing disorder, significantly reduces the quality of life and its diagnosis may be delayed because it is confused with reflux disease. Therefore, it should be followed and treated in experienced hands.

What is Zenker's Diverticulum?

With the enlargement of the upper part of the esophagus, a sac called diverticulum is formed. Food accumulates in this sac and causes complaints. Since the sac called diverticulum blocks the passageway of the esophagus, food cannot pass into the esophagus and swallowing disorder occurs. Undigested food accumulated in the pouch comes back to the mouth. It can escape into the lungs and cause pneumonia. It can cause bad breath. Complaints are more common in older ages.

How is Zenker's Diverticulum Diagnosed?

Diagnosis is mostly made by endoscopy. Barium or contrast-enhanced passage radiographs and tomography can also be used for diagnosis.

How is the treatment done?

Surgical and endoscopic methods are used in the treatment. In open surgery, it is necessary to cut the thorax, since it is necessary to enter the thorax. Or it can be done laparoscopically, with thoracic surgeons opening the neck. However, in these methods, some complications may occur while removing the diverticulum. Stenosis or leaks may develop in the esophagus. In addition, the recovery period is longer in open surgeries compared to endoscopic methods.

How is Endoscopic Treatment Performed?

There are several types of methods. One is the diverticulectomy method; It is intervened directly by cutting the diverticulum muscles. In addition, with the method called “Zenker-Peroral Endoscopic Myotomy (Z-POEM)”, a small incision is made in the esophagus endoscopically, that is, without surgery, to reach the problematic muscles of the diverticulum and these muscles are cut with special endoscopic blades. The small incision is closed with endoscopic clips. Thus, the lumen of the esophagus is opened and the pressure in the esophagus of the person decreases. Food goes into the esophagus as it should, instead of the diverticulum. The process takes about 1 hour. The patient starts to drink liquid foods such as water and compote on the first day after the procedure. On the second day, he/she may start to consume thick foods such as yoghurt and soup. He is discharged from the hospital at the end of the second day.

Does a diverticulum turn into cancer?

Diverticulum increases the risk of cancer. We know that there is an increased incidence of squamatous cell carcinoma within the diverticulum.

Does Diverticulum Cause Pain?

It cannot be said that the diverticulum in the esophagus causes pain. It presents with difficulty in swallowing rather than pain.