Esophageal diverticula

The diverticulum is the protrusion of the wall of the hollow organ ( diverticulum branch from the main path).

Distribution[edit | edit source]

right (formed by all layers of the wall) x false (mucosa and submucosa glistening through the muscle)
traction (arising from external tension) x pulse (arising from increased intraluminal pressure)
according to localization: pharyngoesophageal x parabronchial x epiphrenic

pulse false diverticulum jutting between pars thyreopharyngea and cricopharyngea m. constrictor pharyngis inf.
occurs in cervical achalasia (increased tone of the upper esophageal sphincter)
clinical picture:
- upper dysphagia with regurgitation
- foetor ex ore
- arching on the neck when swallowed
- the possibility of aspiration of the contents with the subsequent development of bronchopneumonia

traction right diverticulum in the area of bifurcation of the trachea is formed by pulling behind the esophageal wall by the scarring inflammatory process of the mediastinal nodes
it is usually not manifested clinically, until at large dimensions it can cause problems by pressure on the surroundings, event. bronchoesophageal fistula may occur

false pulse diverticulum caused by achalasia (lower esophageal sphincter hypertension)
clinical picture: dysphagia

X- ray passage of the contrast agent through the esophagus, barium suspension, in case of suspected perforation we will use iodine suspension
esophageal manometry (assessment of achalasia)
endoscopy

surgical , if the diverticulum is a problem - for larger diverticula resection and suture of the wall (classic or stapler), smaller can be left or submerged
treatment of the cause - in achalasia myotomy is performed in Zenker's diverticulum with upper sphincter hypertension and in epiphenic with lower esophageal sphincter hypertension
administer ATB after surgery (possibility of mediastinitis due to putrefactive processes taking place in the stagnant content of diverticula)
complications of Zenker's diverticulum operation - recurrence of the laryngeal nerve.

- PASTOR, Jan. Langenbeck's medical web page [online]. [feeling. 2009]. < https://langenbeck.webs.com/ >.
  - PASTOR, Jan. Langenbeck's medical web page [online]. [feeling. 2009]. < https://langenbeck.webs.com/ >.

PASTOR, Jan. Langenbeck's medical web page [online]. [feeling. 2009]. < https://langenbeck.webs.com/ >.