Divertículo esofágico bilateral de Killian-Jamieson Translated title: Bilateral Killian-Jamieson esophageal diverticula

The purpose of this study was to reassess the findings of Killian-Jamieson diverticula (i.e., proximal lateral cervical diverticula) on pharyngoesophagograms and to compare the prevalence, clinical findings, and radiographic findings of Killian-Jamieson diverticula with those of Zenker's diverticulum. A computerized search of radiology files revealed 16 patients with Killian-Jamieson diverticula and 26 patients with a Zenker's diverticulum. The double-contrast pharyngoesophagograms and medical records were reviewed retrospectively. Only three (19%) of 16 patients with Killian-Jamieson diverticula had symptoms attributable to the diverticula (suprasternal dysphagia in two and cough in one), and none had aspiration pneumonia. In contrast, 16 (62%) of 26 patients with a Zenker's diverticulum had suprasternal dysphagia and three patients (12%) had aspiration pneumonia. Twenty Killian-Jamieson diverticula were detected on pharyngoesophagograms in 16 patients, including 12 (75%) with unilateral left-sided diverticula and four (25%) with bilateral diverticula. The Killian-Jamieson diverticula had an average maximal dimension of 1.4 cm. Zenker's diverticulum was nearly four times as common as Killian-Jamieson diverticula and had an average maximal dimension of 2.5 cm. Three patients (11%) with a Zenker's diverticulum had reflux of barium from the diverticula into the hypopharynx with overflow aspiration. Finally, gastroesophageal reflux was detected in nearly twice as many patients with a Zenker's diverticulum as with Killian-Jamieson diverticula. Killian-Jamieson diverticula are less common and smaller than Zenker's diverticulum. Killian-Jamieson diverticula are less likely to cause symptoms and are less likely to be associated with overflow aspiration or gastroesophageal reflux than is Zenker's diverticulum.

Diverticula of the oesophagus are rare. They can occur at any level, and are often defined by their anatomical location. Three categories are recognised, namely pharyngo-oesophageal, parabronchial and epiphrenic. Although these diverticula are often asymptomatic, patients can develop significant problems with dysphagia, regurgitation and aspiration. The causation of oesophageal diverticula is controversial; however, the popular current belief is that most occur because of oesophageal dysmotility. This paper demonstrates the categories of oesophageal diverticula pictorially, including the radiological features and underlying pathology.

Killian-Jamieson diverticulum (KJD) is a rare esophageal diverticulum that protrudes through the muscular gap in the anterolateral wall of the proximal cervical esophagus inferior to the cricopharyngeus. Although several patients with bilateral KJD have been reported, high-resolution ultrasound (US) image of bilateral KJD has never been reported. A 71-year-old man visited our hospital for annual follow-up of known thyroid nodules. In addition to the previously noted thyroid nodules, two arc-shaped hyperechoic lesions with reverberation artifacts, which suggested air-containing lesions, were unexpectedly seen posterior to bilateral thyroid lobes. Although the connection between the esophagus and the lesions was not definitely visible on US, our first differential diagnosis was esophageal diverticula. They were confirmed to be bilateral KJD on the following pharyngoesophagography. If US features are not enough to differentiate esophageal diverticulum from suspicious thyroid nodule, pharyngoesophagography can be performed instead of invasive fine-needle aspiration to obtain a definite diagnosis of incidentally detected esophageal diverticulum.