title: Zenker's diverticulum complicating achalasia: a 'cup-and-spill' oesophagus.
abstract: A 72-year-old woman presented with long-standing gastro-oesophageal reflux, regurgitation of swallowed food and worsening cervical dysphagia. Fluoroscopic barium oesophagography revealed a posterolateral pharyngeal pouch (Zenker's diverticulum (ZD)) complicating a 'cup and spill' oesophageal deformity with a smoothly tapered segment at the gastro-oesophageal junction. CT and high-resolution manometry confirmed that the underlying abnormality was a massively dilated oesophagus with aperistalsis and pan-oesophageal pressurisation, consistent with a diagnosis of oesophageal achalasia (type II). She underwent endoscopic stapled diverticulotomy, with good symptomatic relief. We discuss the aetiology of ZD, its management and the association here with oesophageal achalasia.
authors: Department of Otolaryngology-Head and Neck Surgery, Nottingham University Hospitals NHS Trust, Nottingham, UK.
authors: Mark
authors: M
authors: Sayles
authors: Laura
authors: L
authors: Harrison
authors: Julian A
authors: JA
authors: McGlashan
authors: David G
authors: DG
authors: Grant
mesh_terms: D000368:Aged; D000464:Alginates / Q000627:therapeutic use; D003937:Diagnosis, Differential; D004931:Esophageal Achalasia / Q000150:complications* / Q000000981:diagnostic imaging; D004943:Esophagogastric Junction / Q000002:abnormalities; D004945:Esophagoscopy; D004947:Esophagus / Q000002:abnormalities; D005260:Female; D020723:Glucuronic Acid / Q000627:therapeutic use; D006603:Hexuronic Acids / Q000627:therapeutic use; D006801:Humans; D054328:Proton Pump Inhibitors / Q000627:therapeutic use; D011859:Radiography; D016672:Zenker Diverticulum / Q000150:complications* / Q000000981:diagnostic imaging
chemical_list: D000464:Alginates; D006603:Hexuronic Acids; D054328:Proton Pump Inhibitors; D020723:Glucuronic Acid