Massive Zenker diverticulum

August 10, 2012 by Jonathan M. Bock, MD; John J. Petronovich, BS; Joel H. Blumin, MD
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Dysphagia Clinic

Zenker diverticula rarely extend deep into the chest and induce severe dysphagia and aspiration pneumonia. In fact, only rare cases have been reported in the literature that exhibit such significant extension into the mediastinum.

An 81-year-old woman presented to the emergency room with worsening shortness of breath and fevers for several days. Her clinical history demonstrated a multiple-year history of progressive solid and liquid dysphagia with weight loss. Emesis often contained undigested food without the presence of blood or bile. A chest x-ray revealed evidence of aspiration pneumonia and a large mediastinal mass with an air-fluid level that caused anterior tracheal deviation, consistent with a possible Zenker diverticulum (ZD).

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CitationEar Nose Throat J. 2012 August;91(8):319-320