a 68-year - old male patient visited konkuk university hospital due to epigastric pain lasting 2 to 3 seconds 2 months before hospitalization . according to his anamnesis , he was taking 50 mg of atenolol because he had been diagnosed with hypertension 2 years before . he had been diagnosed with esophageal diverticulum 10 years before ; since then he had experienced no symptoms . he underwent a cardiac computed tomography ( ct ) scan 3 weeks prior to hospitalization . the ct scan showed that mild stenosis ( 20% to 30% ) had formed in left anterior descending artery , left circumflex artery , and right coronary artery . he underwent gastroesophageal endoscopy ; 5 cm of diverticulum was found 20 cm from the incisor tooth ( fig . 1 ) . there were no other findings except for erosive gastritis in the antrum of the stomach . the esophagography 2 weeks prior to the hospitalization showed that there was 10 cm of diverticulum projecting to anterolateral side ; killian - jamieson diverticulum ( kjd ) was considered ( fig . although the location of the diverticulum on the esophagogram was right side , we decided left cervical approach for surgeon 's convenience . left cervical incision was conducted under general anesthesia and the cervical esophagus was exposed following dissection along the sternocleidomastoid muscle . diverticulum ( 105 cm sized ) was found with a wide base and which contained a small amount of necrotic tissue ( fig . the diverticulum adhered to circumjacent tissues ; in particular , it strongly adhered to the prevertebral fascia in the rear of the trachea . cervical esophagus proximal to the diverticulum was dissected cautiously and looped with a silastic drain . the diverticulum was excised with a ta 60 stapler ( ethicon endo - surgery , cincinnati , oh , usa ) . esophageal myotomy of about 3 cm was conducted along the distal part of the esophagus after the excision of the diverticulum . reinforcement sutures were inserted with 3 - 0 silk along the excision area of diverticulum . the esophagography on the fourth day after the surgery showed that there were not abnormalities such as leakage or stenosis ; therefore , dietary treatment was initiated . the patient was discharged from konkuk university hospital on the sixth day after the surgery . at the time of discharge follow - up observation has been performed for 6 months , during which the patient has not shown any abnormalities such as diverticulum relapse , dysphagia , or stenosis . kjd is a rare form of esophageal diverticulum which appears through the killian 's dehiscence , a mucosal protrusion below the cricopharyngeal muscle . kjd is similar to zenker 's diverticulum ( zd ) due to the protrusion of esophageal mucosa . kjd is rare in that the incidence of kjd is a fourth of that of zd . the two diseases have similar symptoms ( e.g. , dysphagia , coughing , and chest pain ) . however , according to previous studies , kjd has more non - specific symptoms than zd . location is a standard for distinguishing them : zd occurs mainly in the rear of the esophagus in the upper cricopharyngeal muscle , and kjd occurs mainly in the front or side of the esophagus 2 cm away from the lower cricopharyngeal muscle . the two diseases , zd and kjd , have been observed simultaneously . in rare cases , because of its symptom or greater size , endoscopic treatment and surgical treatment are used for kjd . generally , endoscopic treatment is considered preferable in treating zenker 's diverticula smaller than 3 cm . endoscopic treatment has the possibility of occluded view when there is food or a foreign body in the diverticulum . the treatment of the kjd is more closely adjacent to the recurrent laryngeal nerves than zd . for kjd treatments that do not come into contact with the recurrent nerves , treatments other than endoscopic treatments are preferable . according to the previous studies , the safety of endoscopic treatment has not been established for kjd , due largely to the rarity of cases , and for zd the recurrence rate of endoscopic treatment is 10 times higher than that of surgical treatment . furthermore , myotomy should be adopted as a treatment for kjd , since its treatment is closely related to the prevention of the recurrence of zd from the perspective of the features of diverticular disease . in conclusion , konkuk university hospital experienced the successful treatment of a case of kjd that had been accompanied by rare symptom and discussed the result together with the review of the relevant literary works .
killian - jamieson diverticulum is a rare diverticular disease . 
 this disease differs from zenker 's diverticulum in its location and mechanism . 
 various treatment modality have been attempted , but traditional surgical treatment has been recommended for a symptomatic killian - jamieson diverticulum due to the concern of possible nerve injury . 
 we performed surgical treatment by cervical incision . 
 we report here on a case of killian - jamieson diverticulum and we briefly review the relevant literature .