Zenker’s Diverticulum
Other Known Aliases – pharyngeal diverticulum
Definition – sac-like outpouching of the mucosa and submucosa through Killian’s triangle, which is the area of structural weakness between the cricopharyngeus and lower inferior constrictor muscles.
Clinical Significance – There are actually three different types of diverticulae that can form in this region and are based on anatomic location:
- Zenker’s – immediately above the upper esophageal sphincter
- Traction – near midpoint of the esophagus
- Epiphrenic – immediately above the lower esophageal sphincter
Signs and symptoms of a Zenker’s diverticulum are pretty awful and include dysphagia, pulmonary aspiration, and halitosis from partially rotting food in the outpoaching. It is diagnosed via barium swallow under flouroscopy. The majority of the patients are male and present after the age of 60. Management is surgical resection.
History – Named after Friedrich Albert von Zenker (1825-1898), who was German physician and pathologist and received his medical doctorate at Leipzig in 1851. He held numerous teaching posts including chief prosector and professor of general pathology and anatomy at Dresden city hospital. Dr. Zenker, along with Hugo Wilhelm von Ziemssen, published a case series and literature review on his eponymous diverticulum in 1867 entitled “Krankheiten des Oesophagus”. He also was the first to document and describe trichinosis in a girl who died in 1860, proving that the once thought harmless parasite could cause severe disease.
References
- Firkin BG and Whitwirth JA. Dictionary of Medical Eponyms. 2nd ed. New York, NY; Parthenon Publishing Group. 1996.
- Bartolucci S, Forbis P. Stedman’s Medical Eponyms. 2nd ed. Baltimore, MD; LWW. 2005.
- Yee AJ, Pfiffner P. (2012). Medical Eponyms (Version 1.4.2) [Mobile Application Software]. Retrieved http://itunes.apple.com.
- Whonamedit – dictionary of medical eponyms. http://www.whonamedit.com
- Up To Date. www.uptodate.com
- F. A. Zenker and Hugo Wilhelm von Ziemssen:
Krankheiten des Oesophagus. Leipzig, 1867 - Ueber die Trichinenkrankheit des Menschen. Virchows Archiv für pathologische Anatomie und Physiologie und für klinische Medizin, Berlin, 1860, 18: 561-572.
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