STRUCTURAL DYSPHAGIA DUE TO ZENKER’S DIVERTICULUM: A CASE REPORT AND CLINICAL COURSE

Abstract

Zenker's diverticulum accounts for 60 to 65% of all esophageal diverticula. Fifty percent of these occur between the seventh and eighth decades of life. The most common symptom is dysphagia, and others include halitosis, regurgitation, aspiration, weight loss, and odynophagia. This article presents a clinical case showing the evolution of this structural process that impairs swallowing, during the follow-up period from October 2017 to September 2025. The 61-year-old patient reported a sensation of food retention in the pharynx, nasal reflux with semisolid consistencies and occasionally with liquids, of several years' duration. Clinical evaluation revealed pharyngeal hyporeflexia, confirming the diagnosis of pharyngoesophageal dysphagia with silent penetration using videofluoroscopy of swallowing (VFD). The patient was treated with a Zenker peroral endoscopic myotomy (Z-POEM), which was uncomplicated and resulted in immediate symptomatic improvement. Following swallowing control with a variable frequency drive (VFD), IDDSI levels 6 and 0 were prescribed, with a 5 ml bolus. She remains asymptomatic and tolerates the intake level well.