Giant Zenkers diverticulum treated with diverticulectomy plus myotomy in tertiary hospital: case report

Abstract

Zenker's diverticulum (ZD) is the most common esophageal diverticulum. Its prevalence is higher in older adults. It arises in the area called Killian's triangle, which is an area of weakness in the posterior wall of the upper esophagus, at the level of the upper esophageal sphincter (UES). This area is delimited by the fibers of the thyropharyngeal muscle laterally and by the fibers of the cricopharyngeal muscle (CPM) in the inferior. Due to its composition, it is classified as a false diverticulum because it contains mucosal and submucosal layers in its walls. The predominant symptom in 90% of patients is dysphagia, followed by regurgitation of undigested food content. We present the case of the successful diagnostic approach with tomography and esophageal-gastro-duodenal and therapeutic series with diverticulectomy plus myotomy with the use of a stapler to a patient with usual symptoms of ZD, but with an unusual size: a giant ZD.