Zenker's Diverticulum/ Pharyngeal Pouch
In the posterior pharyngeal wall, there is an inherent weakness between the two parts of the inferior constrictor muscle. This area is called the Killian's dehiscence and it lies between cricopharyngeus below and thyropharyngeus above. The pharyngeal mucosa can herniate through this weakened area and form the Zenker's diverticulum. Symptoms include dysphagia, regurgitation of undigested food and bouts of coughing especially at night. Patients also develop bad breath because of the constant presence of undigested food. Aspiration pneumonia may be a serious complication. The condition is diagnosed via endoscopy and barium swallow. The contrast can be seen filling a pouch behind the pharynx in the image above. Treatment is mainly surgical. It may involve excision of the pouch and separating it from the oesophagus either endoscopically or via cervical approach. Image via: https://www.nejm.org/doi/full/10.1056/NEJMicm1701620 Information via: Diseases of the ear, nose, throat and head and neck surgery- Dhingra, 6th edition