Year 2025 / Volume 117 / Number 7
Letter
Foreign body in Zenker’s diverticulum

413-414

DOI: 10.17235/reed.2024.10484/2024

Marina Vidal Pelayo, Raúl Honrubia López, Guillermo González Redondo, Laura García García, Carmen Comas Redondo,

Abstract
Zenker's diverticulum (ZD) is an uncommon disorder that can cause dysphagia with risk of aspiration. While surgical treatment has been the mainstay for many years, endoscopic diverticulotomy has emerged as a first-line option with favorable outcomes. We present the case of a 93-year-old woman with no significant past medical history who was diagnosed with a 6 cm ZD. Due to dysphagia, she experienced significant weight loss and was at risk of malnutrition. She developed aspiration pneumonia and required admission to our center. Given her condition and inability to swallow, a nasogastric tube was placed under radiological guidance for nutritional support pending definitive treatment. On radiographic localization of the ZD, a radiopaque metallic density image was observed that had not been identified in previous imaging. Suspecting a possible retained foreign body in the large diverticulum, a gastroscopy was performed. During the procedure, the ZD was accessed and a 10 mm metallic object was identified. The object was extracted using a Roth net, confirming the suspicion of a foreign body lodged in the ZD. The metallic piece was later identified as a patient's dental prosthesis. After resolution of the aspiration pneumonia, endoscopic-assisted diverticulotomy was performed. The procedure was carried out under deep sedation with cricopharyngeal myotomy without immediate complications. After 48 hours of hospitalization, the patient was discharged without requiring a nasogastric tube for feeding.
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References
1. Asokkumar R, Ng JPX, Dimatatac FCP, et al. Simplified endoscopic septotomy for a large symptomatic Zenker's diverticulum. Endoscopy. 2023 Dec;55(S 01):E1122-E1123.
2. Ferreira LE, Simmons DT, Baron TH. Zenker’s diverticula: pathophysiology, clinical presentation, and flexible endoscopic management. Dis Esophagus 2008;21:1–8.
3. Naprawa G, Białkowska J. Foreign body in a Zenker's diverticulum (looking for the lost dentures). Prz Gastroenterol. 2014;9(4):254-8.
4. Kropf JA, Jeanmonod R, Yen DM. An unusual presentation of a chronic ingested foreign body in an adult. J Emerg Med. 2013 Jan;44(1):82-4.
5. Simmons DT, Baron TH. Endoscopic retrieval of a capsule endoscope from a Zenker's diverticulum. Dis Esophagus. 2005;18(5):338-9.
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Vidal Pelayo M, Honrubia López R, González Redondo G, García García L, Comas Redondo C. Foreign body in Zenker’s diverticulum. 10484/2024


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Publication history

Received: 15/04/2024

Accepted: 22/04/2024

Online First: 20/05/2024

Published: 08/07/2025

Article Online First time: 35 days

Article editing time: 449 days


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