These lesions result from an increased pressure gradient in the proximal esophagus, which causes herniation of the mucosa through the overlying muscle layers just proximal and posterior to the cricopharyngeal muscle. The etiology of these lesions is related to mechanical incoordination coupled with muscle degeneration.
Symptoms develop as the diverticulum enlarges and traps undigested food.
Patients, usually age 50 to 80, present with halitosis, regurgitation, and aspiration. Repeated aspiration episodes can lead to pneumonia and lung abscesses. The diagnosis is made by history and barium swallow which demonstrates the diverticulum. Care should be taken when performing endoscopy for other reasons, as the diverticulum can be easily ruptured. Patients with radiographic confirmation of the diverticulum should be treated surgically on an elective basis.