Medical expert of the article
New publications
Endoscopic signs of esophageal diverticula
Last reviewed: 06.07.2025
All iLive content is medically reviewed or fact checked to ensure as much factual accuracy as possible.
We have strict sourcing guidelines and only link to reputable media sites, academic research institutions and, whenever possible, medically peer reviewed studies. Note that the numbers in parentheses ([1], [2], etc.) are clickable links to these studies.
If you feel that any of our content is inaccurate, out-of-date, or otherwise questionable, please select it and press Ctrl + Enter.
Esophageal diverticulum is a blind organic protrusion of the esophageal wall of acquired or congenital (less common) nature. Esophageal diverticula account for 40% of all gastrointestinal diverticula.
True diverticula. The wall of the diverticulum contains all the elements of the esophageal wall. They are more often congenital.
False diverticula. These are essentially hernial protrusions of the mucous membrane through weak spots in the muscular wall. They can easily stretch, become strangulated, and perforate.
Diverticula can be:
- single - 70-90%,
- multiple - 10-30%.
According to the mechanism of occurrence, diverticula are:
- Pulsive. They occur as a result of increased pressure in the esophagus due to a disruption in the coordination between pushing food through and opening one of the muscular sphincters - false diverticula.
- Traction. They arise as a result of stretching of the esophageal wall by paraesophageal scar strands - true diverticula.
According to their shape, diverticula can be:
- Spherical.
- Oval.
- Pear-shaped.
- Saccular.
The diameter of the message depends on the shape of the diverticulum and its size.
According to topography, diverticula are:
- Pharyngeal-esophageal. These include cervical diverticula and Zenker's diverticulum. They make up 3-5%. More often congenital, of a pulsation nature, they are located along the back wall of the pharynx and esophagus (prevertebrally). The sizes range from a cherry pit to a child's head.
- Epibronchial (bifurcation, upper thoracic). They make up 70-80%, most often traction, caused by tuberculous bronchoadenitis. They have a wide entrance. Complications are rare.
- Epiphrenic (supradiaphragmatic, lower thoracic), more often pulsation, are located on the anterior and left lateral walls.
Complications of esophageal diverticula.
- Diverticulitis:
- catarrhal - hyperemia of the mucous membrane,
- atrophic - thinning of the mucous membrane,
- erosive-ulcerative,
- fibrinous-purulent,
- cicatricial-deforming.
- Perforation.
- Bleeding.
- Esophageal diverticulum cancer.
The endoscopic protocol must indicate the level of the diverticulum, wall, size, depth, diameter of the entrance opening, nature of the mucosa, contents of the diverticulum, and emptying of the diverticulum.
[