An esophagel diverticulum can be either a pulsion or traction type. The classic presentation is in an elderly male who develops dysphagia, regurgitation of undigested food, and a gurgling sound in the neck.
Pulsion diverticula are usually acquired lesions and are commonly associated with motor dysfunction. They usually develop when the mucosa and submucosa protrudes through a defect in the musculature of the esophagus.
Pulsion diverticula are also known as Zenker’s diverticulum. The most common origin is in the posterior midline of the neck above the cricopharyngeus muscle and below the inferior pharyngeal constrictor muscle.
Treatment of Zenker’s diverticulum is resection and cricopharyngeal myotomy to relax the muscle.
Traction diverticula result when the esophageal wall is pulled by adjacent inflammation. The most typical scenario is enlarged and inflammed peribronchial mediastinal lymph nodes.