Traction Diverticulum
Michael P. Federle, MD, FACR
Key Facts
Imaging
Acquired condition due to subcarinal or perihilar granulomatous lymph node pathology
Chest x-ray PA view: Calcified perihilar lymph nodes
Videofluoroscopic esophagogram (barium studies)
Mid-esophagus: Traction diverticulum
Tented or triangular in shape with pointed tip, wide “mouth”
Diverticulum tends to empty when esophagus is collapsed (because it contains all layers)
Top Differential Diagnoses
Zenker diverticulum
Posterior hypopharyngeal diverticulum
Pulsion diverticulum
Mid and distal esophageal pulsion diverticula tend to remain filled after most of barium is emptied (lack of muscle)
Associated with motility disorders
Esophageal perforation
Sealed-off leak seen as self-contained extraluminal collection of contrast medium that communicates with adjacent esophagus
May be indistinguishable from traction diverticulum without history
Pathology
Pathogenesis: Acutely inflamed, enlarged subcarinal nodes indent and adhere to esophageal wallsRelated posts:
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