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Case of the Week 499


What is the most likely diagnosis?

  • 58 year-old with heartburn



Frontal and Oblique Esophagram-Cervical Esophagus

  1. Perforated Esophagus
  2. Zenker Diverticulum
  3. Cricopharyngeal Bar
  4. Killian-Jamieson Diverticulum
  5. Esophageal Web

Additional Image-None

 

Additional Images

 

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Answer:

 

4. Killian-Jamieson Diverticulum

 

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Killian-Jamieson Diverticulum

General Considerations

  • Arises from cervical esophagus below cricopharyngeal muscle (about C5-C6) laterally
  • Originates on the antero-lateral wall of cervical esophagus through a muscular gap (the Killian-Jamieson space) lateral to longitudinal muscle of the esophagus
  • It is a pulsion, not a true, diverticulum since it does not involve all layers of esophagus
  • Usually smaller than a Zenker diverticulum

 

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is an award-winning educational website aimed primarily at medical students and radiology residents-in-training, containing  lectures, handouts, images, Cases of the Week, archives of cases, quizzes, flashcards of differential diagnoses and “most commons” lists, primarily in the areas of chest, GI, GU cardiac, bone and neuroradiology.