Case #1

27 years old female patient with history of chronic dysphagia

This PA chest x-ray demonstrate an air-fluid level in the superior mediastinum likely arising from the esophagus, the distal esophagus is no dilated. The lung grossly appears clear 

DDx include :

1- Esophageal diverticulum.

2- Infected larynogcele.

3- Infected cyst.

 Enhanced CT scan has been performed 

This an enhanced CT scan at the level of the aortic arch demonstrate an out-pouching arising from the cervical part of the esophagus, no adjacent lymph nodes. Otherwise no gross abnormality could be identified.

The findings are in keeping with esophageal diverticulum(Zenker diverticulum).

Types of esophageal diverticulum:

1- Zenker’s Diverticulum :

Pharyngoesophageal diverticulum, located at the posterior superior aspect at the thyropharyngeal muscle and inferior boundary is cricopharyngeal muscle.

2- Midesophageal Diverticulum

3- Epiphrenic Diverticulum:

Located at the lateral distal part of the esophagus more common on the right side.