PAEA Surgery End Of Rotation (EOR) Practice Exam

What is the most common type of esophageal diverticulum?

1. Traction diverticulum

2. Zenker's diverticulum

3. Epiphrenic diverticulum

4. Mid-esophageal diverticulum

The correct answer is: Zenker's diverticulum

Zenker's diverticulum is indeed the most common type of esophageal diverticulum. It typically occurs in the pharyngoesophageal junction, an area where the pressure from swallowing and other factors can lead to the formation of a pouch. This diverticulum is characterized by its location just above the upper esophageal sphincter, which contributes to its development through a process involving muscle weakness and high intrapharyngeal pressures. Patients with Zenker's diverticulum commonly experience symptoms such as dysphagia (difficulty swallowing), regurgitation of undigested food, halitosis (bad breath), and sometimes aspiration. These clinical features result from food being trapped in the diverticulum and can cause significant discomfort and complications if not managed appropriately. The other types of diverticula mentioned are less common and have different characteristics and locations within the esophagus. Traction diverticula, for example, are typically found in the mid-esophagus and are associated with inflammation and fibrosis, often due to conditions like tuberculosis or malignancies. Epiphrenic diverticula are usually located just above the diaphragm and are more frequently related to motility disorders. Mid-esophageal diverticula, while present, do not occur as frequently as Zenker's. Thus, the prominence of