A preventable medical error: Successful management of iatrogenic Zenker's diverticulum perforation.

Abstract

Introduction and significance: Zenker's diverticulum is a rare condition characterized by a false diverticulum, as a true diverticulum involves herniation of all wall layers outward. Dysphagia, difficulty in swallowing, is the most common symptom. Diagnosis is primarily made through X-ray studies using contrast material during swallowing. Treatment options include open surgery or endoscopy.

Case presentation: We present the case of an adult male who experienced progressive dysphagia for approximately two years. A diagnosis of Zenker's diverticulum was confirmed by radiography following unsuccessful endoscopic treatment and a subsequent perforation of the diverticulum. The patient underwent successful open surgery after adequate preoperative preparation.

Clinical discussion: Zenker's diverticulum is an uncommon cause of pharyngeal dysphagia, but it should be considered in the differential diagnosis due to the importance of early intervention and prevention of malignancy. The endoscopic approach carries a significant risk of perforation, necessitating careful treatment and close monitoring during and after the procedure.

Conclusion: The endoscopic approach is considered the best treatment method for Zenker's diverticulum and should be used with caution to avoid complications, especially perforation, which makes open surgery the most appropriate treatment in this case.