Eur J Cardiothorac Surg 2007;32:659. doi:10.1016/j.ejcts.2007.06.038
Copyright © 2007, European Association for Cardio-Thoracic Surgery. Published by Elsevier B.V. All rights reserved
Images in cardio-thoracic surgery |
Bilateral Zenker's diverticulum plus middle esophageal diverticulum
Ugo Cioffia,*,
Matilde De Simonea,
Alessandro Lemosb,
Maurizio Gallieraa
a University of Milan, Department of Surgery, Fondazione IRCCS, Ospedale Maggiore Policlinico, Milano, Italy
b Department of Radiology, Fondazione IRCCS, Ospedale Maggiore Policlinico, Milano, Italy
Received 21 May 2007;
received in revised form 27 June 2007;
accepted 28 June 2007.
* Corresponding author. Address: Department of Surgery, Fondazione IRCCS, Ospedale Maggiore Policlinico, Via F. Sforza 35, 20122 Milano, Italy. Tel.: +39 02 55035568; fax: +39 02 55034165. (Email: ugo.cioffi{at}unimi.it).
Key Words: Zenker's diverticulum • Pharyngoesophageal diverticulum • Middle esophageal diverticulum
A 65-year-old man exhibited pyrosis and recurrent episodes of regurgitation. Barium swallow showed a bilateral Zenker's diverticulum plus middle third esophageal diverticulum (Fig. 1
). The patient refused an upper digestive endoscopy as well as an esophageal manometry. As he was asymptomatic with antacid agents he was referred to the Gastroenterology Unit.
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Fig. 1. Barium swallow showing a bilateral outpouching of the esophageal wall near the pharyngoesophageal junction due to the presence of bilateral side-by-side symmetrical Zenker's diverticula with an average diameter of 3 cm each. At the middle-third of the esophageal wall there was an additional diverticulum (arrow) (panel A). A lateral view confirms the presence of Zenker's diverticula in the cervical esophagus and the diverticulum in the middle esophagus (arrow) (panel B).
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