Endoscopic management of a large and difficult Zenker diverticulum in a nonagenarian

Abstract Text A 90-year-old female presented with dysphagia and aspiration pneumonia. She was found to have a 7cm Zenker diverticulum.

Only a pediatric endoscope was able to be advanced to the esophagus and a wire was advanced. Cricopharyngeomyotomy was performed using an insulated scissor knife. The septum was divided to the base of the diverticulum. Bleeding was managed with coagulation graspers. The endoscope was passed easily to the esophagus. A Schatzki ring was dilated.

Clips were applied at the bottom of the cut. Esophagram showed no extravasation. The contrast entered the esophagus easily. The patient tolerated a soft diet very well.

Conflicts of interest

Authors do not have any conflict of interest to disclose.

Publication History

Article published online:
14 April 2023