Diseases

Diverticulum of the esophagus (esophageal diverticulum)

Diverticulum of the esophagus (esophageal diverticulum)


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Esophageal diverticula are sac-like protuberances in limited areas of the esophagus wall. Esophageal diverticula can be congenital or acquired; real diverticula can also be distinguished from pseudodiverticula. There are typical symptoms that do not necessarily have to occur. Older men are more often affected and diverticula in the food pipe are rather rare in people under the age of forty. In addition to the esophagus, diverticula are often found in the colon, so-called colon diverticula or diverticulosis. In principle, however, the entire digestive tract can be affected.

The esophagus

The esophagus is the thumb-thick, approx. 25 cm long tube-like connection between the throat and stomach. The muscle tube is located between the spine and trachea and leads down through the so-called Larray column through the diaphragm, where it passes into the stomach. The esophagus consists of three layers of wall:

  • the outer muscle layer,
  • a connective tissue shift layer and
  • the mucous membrane inside the organ.

In these layers, sags occur from the inside out, which can also be imagined as “indentations” in the mucous membrane.

"Real" and "false" diverticula

A distinction is made between two different forms of protuberance in the esophagus. In the case of the powder diverticulum, the protuberance arises from an imbalance between internal pressure and wall stability. If the diverticulum is formed by external tension, for example a scar after inflammation, I am dealing with a traction diverticulum.

A distinction is also made between real diverticula, in which all wall layers are affected by the protuberances, and pseudodiverticles, which only represent protuberances of the mucous membrane due to muscle gaps.

Symptoms and complications of the Zenker diverticulum

So-called Zenker pulsation diverticula occur most frequently (around 70 percent of those affected), which means that pseudodiverticula have formed in the upper area of ​​the esophagus. Typical symptoms for Zenker emulsion diverticula include:

  • Difficulty swallowing with pressure behind the sternum and
  • this triggered a foreign body sensation in the throat,
  • bad breath (foetor ex ore) and
  • Coughing sensation that occurs immediately after eating.

However, typical cardinal symptoms of an esophageal diverticulum are gurgling noises when drinking and leftovers on the pillow, which are occasionally noticed in the morning.

Complications can arise when backflowing food particles enter the airways. This can lead to pneumonia (aspiration pneumonia). In addition, inflammation (diverticulitis) can occur, leading to perforation, i.e. lead to breakthrough of the esophagus wall.

Diagnosis

There are three different methods to diagnose a diverticulum in the esophagus and to clarify the type and form of the bulge and thus also determine the treatment method:

  • Esophageal swallow, a contrast-enhanced imaging procedure,
  • Manometry to take a pressure measurement inside the esophagus or
  • an endoscopic examination (but is rarely used because of possible injuries).

Symptom relief and therapy

So far, the conventional therapy has been surgical removal of the esophageal diverticulum. Depending on the severity of the disease and the location of the diverticula, an open surgical procedure may be necessary or it may be done endoscopically.

To relieve symptoms until the procedure, it is advisable to eat several small meals throughout the day and to avoid foods that can cause gastric acid to reflux into the esophagus, such as:

  • Alcohol,
  • sour dishes,
  • greasy food and
  • Sweets.

(fp, ok)

Author and source information

This text corresponds to the requirements of the medical literature, medical guidelines and current studies and has been checked by medical doctors.

Dipl. Geogr. Fabian Peters, Barbara Schindewolf-Lensch

Swell:

  • Merck and Co., Inc .: Bagging (diverticulum) of the esophageal wall (esophageal diverticulum) (accessed: July 16, 2019), msdmanuals.com
  • Vogelsang, Arnd / Schumacher, Brigitte 7 Neuhaus, Horst: Treatment of Zenker's diverticulum, Dtsch Arztebl 2008, aerzteblatt.de
  • Jena University Hospital: Zenker's diverticulum (hypopharyngeal diverticulum) (access: July 16, 2019), uniklinikum-jena.de
  • Amboss GmbH: Esophageal diverticulum (accessed: July 16, 2019), amboss.com
  • Cleveland Clinic: Esophageal Diverticulum (accessed: July 16, 2019), my.clevelandclinic.org
  • Conklin, Jeremy H. / Singh, Deepak / Katlic, Mark R .: Epiphrenic Esophageal Diverticula: Spectrum of Symptoms and Consequences, The Journal of the American Osteopathic Association, 2009, jaoa.org

ICD codes for this disease: K22ICD codes are internationally valid encodings for medical diagnoses. You can find e.g. in doctor's letters or on disability certificates.



Video: Diverticula, diverticulosis, u0026 diverticulitis - an Osmosis preview (December 2022).