Physical Address
304 North Cardinal St.
Dorchester Center, MA 02124
Lateral Cervical Esophageal Diverticulum
KEY FACTS
Terminology
-
Synonym: Killian-Jamieson diverticulum
-
Lateral outpouching from proximal cervical esophagus below cricopharyngeus muscle
Imaging
-
Small, smoothly marginated lateral sac
-
Usually unilateral , left sided
-
Bilateral in 25%; rarely unilateral, right sided
-
Diameter: 0.2-5.0 cm; average: 1.4 cm
-
Barium swallow (frontal & lateral) best imaging tool
-
Lateral sac; overlaps anterior esophageal wall
-
-
Incidental finding on CECT/MR
-
Round or oval mass lateral to esophagus
-
Abuts and may displace left thyroid lobe &/or common carotid artery anteriorly
-
Contents may be air, fluid, food debris, or mixed
-
Top Differential Diagnoses
-
Esophago-pharyngeal (Zenker) diverticulum
-
Thyroid carcinoma nodal metastasis
-
Parathyroid cyst
Pathology
-
Protrusion through Killian-Jamieson triangle in anterolateral wall of cervical esophagus
-
Zenker at posterior midline Killian dehiscence
-
Clinical Issues
-
Rare, usually asymptomatic, incidental imaging finding
-
May have dysphagia from pharyngeal dysmotility
-
Respiratory symptoms uncommon
-
Cricopharyngeus prevents reflux to hypopharynx
-
-
Most not surgically treated due to asymptomatic nature
-
Diverticulectomy ± esophagomyotomy if symptomatic
-
Axial CECT shows an air-filled diverticulum
interposed between the cervical esophagus, left thyroid lobe
, and common carotid. Note the air "points"
toward esophagus, a clue to its origin.
interposed between the cervical esophagus, left thyroid lobe , and common carotid. Note the air "points" toward esophagus, a clue to its origin.
Frontal esophagram shows a prominent diverticular outpouching
from the left lateral cervical esophageal wall
compatible with a lateral cervical esophageal diverticulum (Killian-Jamieson). This lesion is below the level of the indentation from the cricopharyngeus muscle
.
from the left lateral cervical esophageal wall compatible with a lateral cervical esophageal diverticulum (Killian-Jamieson). This lesion is below the level of the indentation from the cricopharyngeus muscle .
Axial T2 FS MR shows an irregular mass
lateral to the cervical esophagus
. The mass has an air-fluid level with hyperintense fluid layering posteriorly and subtly "points" toward the cervical esophagus
, suggesting its organ of origin.
lateral to the cervical esophagus . The mass has an air-fluid level with hyperintense fluid layering posteriorly and subtly "points" toward the cervical esophagus , suggesting its organ of origin.
Axial T1 C+ FS MR reveals an esophageal diverticulum as an air-filled hypointense structure
in the lower neck posterior to the left thyroid lobe
and lateral to the cervical esophagus
. The left common carotid artery is also displaced anteriorly, lateral to the thyroid.
in the lower neck posterior to the left thyroid lobe and lateral to the cervical esophagus . The left common carotid artery is also displaced anteriorly, lateral to the thyroid.
TERMINOLOGY
Synonyms
-
Killian-Jamieson diverticulum, proximal lateral cervical esophageal diverticulum
-
Lateral pharyngoesophageal diverticulum
Definitions
-
Lateral outpouching from proximal cervical esophagus
You're Reading a Preview
Become a Clinical Tree membership for Full access and enjoy Unlimited articles
If you are a member. Log in here
