What are the three types of oesophageal diverticulae?
1. Zenker (upper third) 2. Traction/Pulsion (middle third) 3. Epiphrenic (lower third)
Upper oesophageal diverticulae occur at what anatomical site?
Zenker's diverticulae occur at Killian's dehiscence (between the inferior constrictor and cricopharyngeus).
Are pulsion oesophageal diverticulae "true" diverticulae?
No (only mucosa and submucosa). True diverticulae consist of all three mural layers: 1. Mucosa / submucosa 2. Muscularis propria 3. Adventitia
What is the difference between pulsion and traction diverticulae? What might have caused this patients diverticulum?
Pulsion diverticulae are caused by increased intraluminal oesophageal pressure. Traction diverticulae are caused by fibrosis in adjacent tissue (and are usually true diverticula). This patient appears to have a traction divertciulum and is likely due to tuberculous adenitis or previous surgery leading to para-oesophageal fibrosis.
Outpouching of the posterior aspect of the middle third of the oesophagus fills with barium and air. Spontaneous empyting is observed.