Zenker’s diverticulum is a pouch that forms at the back of the throat at the junction of the pharynx and the esophagus (the food passage to the stomach). The pouch causes problems with swallowing.

The growth is most common in people over the age of 60. However, physicians at Duke have seen patients in their 30s who have Zenker’s diverticulum.

The cause of Zenker’s diverticulum is unknown. The formation of the pouch does not appear to be hereditary. In many patients who have a Zenker’s diverticulum, other problems of the esophagus are present -- however, this is not always the case.

Symptoms and Diagnosis

The most common symptom of Zenker’s diverticulum is difficulty swallowing food. Food may actually come back up out of the mouth several minutes to even hours after eating.

Patients also suffer from choking, feeling mucus collecting in the throat, hoarseness, or bad breath. The symptoms can be quite embarrassing and debilitating.

In patients with symptoms suggestive of Zenker’s diverticulum, a very simple and safe x-ray called a barium swallow is performed.

Slide Show

Click the arrows below to browse through the slide show of barium swallow x-rays. For a larger version of a picture, click the image.

Barium swallow x-ray of a Zenker’s diverticulum

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Barium swallow x-ray of a hypopharyngeal diverticulum

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Barium swallow x-ray of a hypopharyngeal diverticulum

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Barium swallow x-ray of a hypopharyngeal diverticulum

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Barium swallow x-ray of a hypopharyngeal diverticulum

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Surgical Treatment

Endoscopic staple diverticulostomy (ESD) is a minimally invasive surgical procedure used to treat patients with Zenker’s diverticulum.

This treatment was originally developed and pioneered by Richard Scher, MD, at Duke University Medical Center. Scher was the first surgeon to perform this treatment in the United States, and he has used ESD to treat more patients with Zenker’s diverticulum than anyone else in the U.S.

More than 95 percent of the patients Scher has treated by ESD have had a successful result.

ESD has many advantages over other types of surgery that have been used to treat patients with Zenker’s diverticulum. Some of these include:

• Safer
• Performed more quickly
• Usually outpatient
• Less pain
• Eat sooner
• No incisions on the skin
• Very effective relief of symptoms

Learn more about ESD

Physicians

Physicians offering this service include:

• Cohen, Seth M.
  • Surgery / Otolaryngology-Head and Neck Surgery
  • Pediatrics / Otolaryngology–Head and Neck Surgery
• Scher, Richard L.
  • Surgery / Otolaryngology-Head and Neck Surgery
• Witsell, David L.
  • Surgery / Otolaryngology-Head and Neck Surgery
  • Pediatrics / Otolaryngology–Head and Neck Surgery

Locations

This service is available at:

• Duke Otolaryngology, Head and Neck, ENT
  Duke Clinic 1H, Purple Zone, 200 Trent Drive, Durham, NC 27710