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Journal of the National Medical Association logoLink to Journal of the National Medical Association
. 2006 Jul;98(7):1177–1180.

Ulcer in the basis of Zenker's diverticulum mimicking esophageal malignancy.

Bolent Odemis 1, Hilmi Ataseven 1, Omer Basar 1, Ibrahim Ertugrul 1, Osman Yüksel 1, Nesrin Turhan 1
PMCID: PMC2569451  PMID: 16895291

Abstract

Complications of Zenker's diverticulum are rare and include ulcer, bleeding and malignancy. Ulcer in the basis of diverticulum is a very rare complication and to date only four cases have been reported in the literature. Herein, we report a new case of ulcer in Zenker's diverticulum mimicking esophageal malignancy presumed to be due to aspirin and/or alcohol consumption. The exact diagnosis was troublesome and needed to perform diagnostic procedures repeatedly. The patient underwent external pharyngoesophageal diverticulectomy. We emphasize that endoscope should be withdrawn if any resistance is encountered during esophageal intubation-even with forward-viewing endoscope-especially when there is a Zenker's diverticulum suspicion and the patient receives ulcerogenic agents. Endoscopic examination should be performed prior to any definitive surgical procedure in all patients with Zenker's diverticulum.

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Selected References

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  1. Achkar E. Zenker's diverticulum. Dig Dis. 1998 May-Jun;16(3):144–151. doi: 10.1159/000016858. [DOI] [PubMed] [Google Scholar]
  2. Bor S., Bor-Caymaz C., Tobey N. A., Abdulnour-Nakhoul S., Orlando R. C. Esophageal exposure to ethanol increases risk of acid damage in rabbit esophagus. Dig Dis Sci. 1999 Feb;44(2):290–300. doi: 10.1023/a:1026646215879. [DOI] [PubMed] [Google Scholar]
  3. Bradley P. J., Kochaar A., Quraishi M. S. Pharyngeal pouch carcinoma: real or imaginary risks? Ann Otol Rhinol Laryngol. 1999 Nov;108(11 Pt 1):1027–1032. doi: 10.1177/000348949910801102. [DOI] [PubMed] [Google Scholar]
  4. Fergus Icilma, Bennett Edward S., Rogers David M., Siskind Steven, Messineo Frank C. Fluoroscopic balloon-guided transesophageal echocardiography in a patient with Zenker's diverticulum. J Am Soc Echocardiogr. 2004 May;17(5):483–486. doi: 10.1016/j.echo.2004.01.008. [DOI] [PubMed] [Google Scholar]
  5. Hendren W. G., Anderson T., Miller J. I. Massive bleeding in a Zenker's diverticulum. South Med J. 1990 Mar;83(3):362–362. doi: 10.1097/00007611-199003000-00033. [DOI] [PubMed] [Google Scholar]
  6. Kensing K. P., White J. G., Korompai F., Dyck W. P. Massive bleeding from a Zenker's diverticulum: case report and review of the literature. South Med J. 1994 Oct;87(10):1003–1004. [PubMed] [Google Scholar]
  7. Malik A., Chitnavis V., Epstein A. Use of a hydrophilic wire for esophageal intubation in Zenker's diverticulum. Gastrointest Endosc. 1994 Jul-Aug;40(4):523–524. doi: 10.1016/s0016-5107(94)70236-5. [DOI] [PubMed] [Google Scholar]
  8. Mincis M., Chebli J. M., Khouri S. T., Mincis R. Etanol e o trato gastrointestinal. Arq Gastroenterol. 1995 Jul-Sep;32(3):131–139. [PubMed] [Google Scholar]
  9. Nutter Kathryn M., Ball Ottis G. Esophageal diverticula: current classification and important complications. J Miss State Med Assoc. 2004 May;45(5):131–135. [PubMed] [Google Scholar]
  10. Shirazi K. K., Daffner R. H., Gaede J. T. Ulcer occurring in Zenker's diverticulum. Gastrointest Radiol. 1977 Oct 25;2(2):117–118. doi: 10.1007/BF02256480. [DOI] [PubMed] [Google Scholar]
  11. Siddiq M. A., Sood S., Strachan D. Pharyngeal pouch (Zenker's diverticulum). Postgrad Med J. 2001 Aug;77(910):506–511. doi: 10.1136/pmj.77.910.506. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Smith Shane R., Genden Eric M., Urken Mark L. Endoscopic stapling technique for the treatment of Zenker diverticulum vs standard open-neck technique: a direct comparison and charge analysis. Arch Otolaryngol Head Neck Surg. 2002 Feb;128(2):141–144. doi: 10.1001/archotol.128.2.141. [DOI] [PubMed] [Google Scholar]
  13. Stöckli S. J., Schmid S. Das Zenkersche Divertikel. Schweiz Med Wochenschr. 2000 Apr 22;130(16):590–596. [PubMed] [Google Scholar]
  14. Vaghei R., Harrison I., Ortiz R. A. Massive bleeding from the pharyngoesophageal diverticulum. Am Surg. 1976 Dec;42(12):917–919. [PubMed] [Google Scholar]
  15. Wai Chun Tao, Yeoh Khay Guan, Ho Khek Yu. Esophageal intubation with duodenoscope in the presence of pharyngeal pouch by a guidewire and catheter-guided technique. Surg Laparosc Endosc Percutan Tech. 2002 Oct;12(5):362–363. doi: 10.1097/00129689-200210000-00012. [DOI] [PubMed] [Google Scholar]

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