Zenker Diverticulum in Systemic Sclerosis–Related Achalasic Megaesophagus
A 56-year-old woman with a 14-year history of limited cutaneous systemic sclerosis presented with a few months' history of sense of a lump in the throat after feeding followed by regurgitation, reappearance of ingested food in the mouth, cough, and halitosis. She had a 7-year history of Barrett esophagus and dysphagia to solid foods and liquids due to achalasic megaesophagus as shown by the barium swallow evaluation of 3 years earlier (Fig. A). A physical examination at the time of the current presentation revealed moderate tenderness and swelling of the left side of the neck. Computed tomography performed with the administration of contrast material showed the presence of a Zenker diverticulum on the left lateral aspect of esophagus (Fig. B and C). The patient underwent diverticulotomy, and at the 6-month follow-up visit, she had complete remission of the symptoms.