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Zenker Diverticulum — RACP Adult Medicine MCQ

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EasyGastroenterology & HepatologyZenker DiverticulumRACP Adult Medicine

A 70-year-old man with progressive dysphagia for solids is found to have a Zenker diverticulum on barium swallow. He has recurrent aspiration pneumonia. What is the anatomical location of a Zenker diverticulum?

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Correct answer: C — Anterior cervical oesophagus

A Zenker diverticulum is a posterior pulsion diverticulum arising through Killian's dehiscence (the weak point between the inferior pharyngeal constrictor and the cricopharyngeus muscle – upper oesophageal sphincter). It presents with dysphagia, regurgitation of undigested food (often hours after eating), halitosis, and aspiration pneumonia. Diagnosis is by barium swallow (NOT endoscopy – risk of perforation). Treatment for symptomatic diverticula is endoscopic or surgical cricopharyngeal myotomy with diverticulectomy or diverticulopexy.

Reference: eTG – 2025 – Gastrointestinal