Killian-Jamieson diverticulum

Killian-Jamieson diverticula are esophageal diverticula. Like the more common Zenker diverticulum, it is a false diverticulum and represents an outpouching of mucosa through a muscular defect (in this case the Killian-Jamieson space ).

Pathology

They are located just below the cricopharyngeus muscle, anteriorly and laterally, as left-sided, or less commonly bilateral, outpouching(s) from the cervical esophagus. High intraluminal pressure due to functional esophageal obstruction may be the cause for the herniation of mucosa through the potential site of weakness in the lateral esophageal wall .

A Killian-Jamieson diverticulum is infrequently encountered as compared with a Zenker diverticulum. Not only are they smaller than a Zenker diverticulum (usually <1.5 cm), but they are only occasionally symptomatic.

Radiographic features

On pharyngoesophagography, it usually appears as a left-sided outpouching from the proximal cervical esophagus below the cricopharyngeus. Less frequently, the outpouchings may be bilateral (25%).

Practical points

It may be encountered on thyroid ultrasound. It changes its shape during ultrasound when the patient swallows. If it is uncertain on static ultrasound images, swallowing maneuvers can be performed with cine ultrasound .

Differential diagnosis

On CT an air bubble in the angle between esophagus and trachea has another DDX : tracheal diverticulum wich usually is smaller and most often on the right side.

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