A Patient With a Zenkers Diverticulum Showing Symptoms Similar to Acute Coronary Syndrome

Keita Oyama, Nobuhiro Akuzawa, Toshihiro Suga, Takashi Hatori, Kunihiko Imai, Yonosuke Kitahara, Masahiko Kurabayashi

Abstract


A 61-year-old man with no significant medical history was admitted to our hospital because of upper chest pain and discomfort. Urgent coronary angiography with possible diagnosis of acute coronary syndrome (ACS) showed normal findings. Further questioning after coronary angiography revealed that patients symptoms had gotten worse soon after swallowing a piece of sushi without chewing. Computed tomography of the chest revealed air particles outside the posterior hypopharynx wall, and subsequent esophagography showed Zenkers diverticulum (ZD) of about 1 cm in diameter. The discomfort resolved on day 2. Findings on esophageal manometry and upper gastrointestinal endoscopy showed no remarkable abnormalities, and the entrance of the ZD could not be identified on endoscopic examination. The patient was discharged on day 7 without any complications. Physicians should know that esophageal diseases, including ZD, might show symptoms mimicking ACS, and that not obtaining a detailed clinical history can lead to misdiagnosis.




J Med Cases. 2015;6(12):576-579
doi: https://doi.org/10.14740/jmc2311w

Keywords


Chest discomfort; Computed tomography; Esophagography; Zenker’s diverticulum

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