Diverticula may occur in the esophagus at upper and lower ends.
The upper or Zenker's diverticulium begins as muscle hypertrophy that may be a response to long-term reflux and an incompetent lower sphincter (LES).
Over time, the hypertrophy of the UES or upper esophageal sphincter cause a bulge in the lower pharynx that becomes a Zenker's.
Treatment is based on reducing the hypertrophy by use of PPI's and if not enough, a myotomy.
A crico-pharyngeal myotomy may be approached either externally or trans-oral using a specific Weerda diverticuloscope, stapler, laser and a harmonic scalpel.
Zenker's Video