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

Clinical Findings

• Usually asymptomatic
• May produce reflux and aspiration

Imaging Findings

• Smooth-walled, contrast-containing pouch on barium swallow
• Most often unilateral and left-sided
• May be bilateral

Differential Diagnosis

• Zenker’s diverticulum
• Arises above cricopharyngeal muscle in midline posteriorly
• Develops at anatomically weak posterior zone (Killian’s dehiscence)

Treatment

• Only patients who are symptomatic or who have large diverticula are offered treatment
• Treatment options are either surgical or endoscopic

Killian-Jamieson Diverticulum. Left: Frontal view from a barium swallow shows an outpouching of barium (white arrow) arising laterally from the cervical esophagus. Right: The diverticulum (yellow arrow) is anterior to the normal esophagus.
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Killian-Jamieson Diverticula: Radiographic Findings in 16 Patients. SE Rubesin and MS Levine. AJR July 2001 vol. 177 no. 1 85-89

Killian-Jamieson Diverticulum: The Rarer Cervical Esophageal Diverticulum. CH Chea,  SL Siow, TW Khor and NA Nik Azim. Malaysia Vol 66 No 1 March 201