IS Case 144: Killian-Jamieson Diverticulum
Imaging Sciences URMC 2008
Publication Date: 2009-05-21
History
A 39-year-old female was sent for an esophagram after an unsuccessful upper endoscopy. Endoscopy visualized questionable posterior tear at the level of the cricopharyngeus muscle with blood in the esophageal lumen. There was clinical suspicion of perforation.
Findings
There is a large left anterior-lateral diverticulum with neck at the level of C6 vertebral body. The diverticulum extends at least 2-1/2 vertebral bodies. It has multiple filling defects within its lumen which may represent clot. No evidence of contrast extravasation was seen on this images as well.
Diagnosis
Killian-Jamieson Diverticulum
Discussion
A Killian-Jamieson diverticulum is a pulsion diverticulum protruding below the cricopharyngeus muscle attachment of the cricoid cartilage through the Killian-Jamieson space delineated laterally by the suspensory ligaments of the esophagus insertion into the cricoid cartilage. It is usually located anterior-laterally to the upper esophagus, just below the level of the crycopharyngeus muscle. Bilateral occurrence is more common than unilateral. The symptomatology is similar to the symptoms seen with Zenker's diverticulum. In this case, the endoscope was inadvertently placed into the diverticulum. Attempts to pass the scope triggered bleeding and the endoscopy was stopped. The blood clots are visualized as filling defects on the esophagram.
References
- Johnson CD, Schmit GD. Mayo Clinic Gastrointestinal Imaging Review. Rochester, MN: Mayo Clinic Scientific Press, 2005: 46.
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