TY - JOUR T1 - Zenker’s diverticulum complicating achalasia: a ‘cup-and-spill’ oesophagus JF - BMJ Case Reports DO - 10.1136/bcr-2013-200702 VL - 2013 SP - bcr2013200702 AU - Mark Sayles AU - Laura Harrison AU - Julian A McGlashan AU - David G Grant Y1 - 2013/12/12 UR - http://casereports.bmj.com/content/2013/bcr-2013-200702.abstract N2 - A 72-year-old woman presented with long-standing gastro-oesophageal reflux, regurgitation of swallowed food and worsening cervical dysphagia. Fluoroscopic barium oesophagography revealed a posterolateral pharyngeal pouch (Zenker’s diverticulum (ZD)) complicating a ‘cup and spill’ oesophageal deformity with a smoothly tapered segment at the gastro-oesophageal junction. CT and high-resolution manometry confirmed that the underlying abnormality was a massively dilated oesophagus with aperistalsis and pan-oesophageal pressurisation, consistent with a diagnosis of oesophageal achalasia (type II). She underwent endoscopic stapled diverticulotomy, with good symptomatic relief. We discuss the aetiology of ZD, its management and the association here with oesophageal achalasia. ER -