A Killian–Jamieson diverticulum is an outpouching of the

esophagus The esophagus (American English), oesophagus (British English), or œsophagus (Œ, archaic spelling) (American and British English spelling differences#ae and oe, see spelling difference) all ; : ((o)e)(œ)sophagi or ((o)e)(œ)sophaguses), c ...

just below the

upper esophageal sphincter The esophagus (American English), oesophagus (British English), or œsophagus ( archaic spelling) ( see spelling difference) all ; : ((o)e)(œ)sophagi or ((o)e)(œ)sophaguses), colloquially known also as the food pipe, food tube, or gullet, ...

. The physicians that first discovered the diverticulum were

Gustav Killian Gustav Killian (2 June 1860 – 24 February 1921) was a Germans, German Laryngology, laryngologist and founder of the bronchoscopy. Life and death His father Johann Baptist Caesar Killian (1820–1889), the son of a ''städtischen Wegeaufsehers'' a ...

and James Jamieson. Diverticula are seldom larger than 1.5 cm, and are less frequent than the similar Zenker's diverticula. As opposed to a Zenker's, which is typically a posterior and inferior outpouching from the

, a Killian–Jamieson diverticulum is typically an anterolateral outpouching at the level of the C5-C6 vertebral bodies, due to a congenital weakness in the cervical esophagus between the oblique and transverse fibers of the

cricopharyngeus muscle The inferior pharyngeal constrictor muscle is a skeletal muscle of the neck. It is the thickest of the three outer pharyngeal muscles. It arises from the sides of the cricoid cartilage and the thyroid cartilage. It is supplied by the vagus nerve ...

. It is usually smaller in size than a Zenker's diverticulum, and typically

asymptomatic Asymptomatic (or clinically silent) is an adjective categorising the medical conditions (i.e., injuries or diseases) that patients carry but without experiencing their symptoms, despite an explicit diagnosis (e.g., a positive medical test). P ...

. Although congenital, it is more commonly seen in elderly patients. Because of its relatively anterior positioning compared to a Zenker's diverticulum, surgical intervention to fix a Killian-Jamieson diverticulum has a higher risk of injury to the

recurrent laryngeal nerve The recurrent laryngeal nerve (RLN), also known as nervus recurrens, is a branch of the vagus nerve ( cranial nerve X) that supplies all the intrinsic muscles of the larynx, with the exception of the cricothyroid muscles. There are two recur ...

Signs and symptoms

When it comes to Killian-Jamieson diverticulum, the vast majority of patients are asymptomatic.

Dysphagia Dysphagia is difficulty in swallowing. Although classified under " symptoms and signs" in ICD-10, in some contexts it is classified as a condition in its own right. It may be a sensation that suggests difficulty in the passage of solids or l ...

is the most common presentation for patients. Additional recurrent symptoms include aspiration,

halitosis Bad breath, also known as halitosis, is a symptom in which a noticeably unpleasant breath odour is present. It can result in anxiety among those affected. It is also associated with depression and symptoms of obsessive compulsive disorder. Th ...

coughing A cough is a sudden expulsion of air through the large breathing passages which can help clear them of fluids, irritants, foreign particles and microbes. As a protective reflex, coughing can be repetitive with the cough reflex following three ...

globus sensation Globus pharyngeus (also termed globus sensation) is the persistent but painless sensation of having a pill, food bolus, or some other sort of obstruction in the throat when there is none. Swallowing is typically performed normally, so it is not ...

, and

neck pain The neck is the part of the body in many vertebrates that connects the head to the torso. It supports the weight of the head and protects the nerves that transmit sensory and motor information between the brain and the rest of the body. Addition ...

Causes

It's still unknown what causes Killian-Jamieson diverticulum. Numerous theories have been put forth. A notable rise in intraluminal pressure was hypothesized by one author as a result of functional outflow obstruction brought on by the circular esophageal muscle contracting. A different author proposed that there may be a similar pathophysiology between the etiology of Killian-Jamieson diverticulum and Zenker's diverticula.

Diagnosis

Imaging usually confirms the diagnosis because a barium esophagram can show the location, size, and lateralization of the lesion. Although there are other modalities such as esophageal endoscopy,

CT scan A computed tomography scan (CT scan), formerly called computed axial tomography scan (CAT scan), is a medical imaging technique used to obtain detailed internal images of the body. The personnel that perform CT scans are called radiographers or ...

, and

ultrasound Ultrasound is sound with frequency, frequencies greater than 20 Hertz, kilohertz. This frequency is the approximate upper audible hearing range, limit of human hearing in healthy young adults. The physical principles of acoustic waves apply ...

, most clinicians rely on barium esophagram to make clinical decisions.

Treatment

Expectant management makes sense for asymptomatic patients. Patients experiencing symptoms can have a variety of surgical options available to them, such as transcervical diverticulectomy combined with esophagomyotomy.

References

External links

{{DEFAULTSORT:Killian-Jamieson diverticulum Esophagus disorders