45yearold man complaining of vomiting Vomitus consist of food mass taken few days back, foul smelling breath and occasional dysphagia to solid food. Diagnosis is: March 2005

Ans. D: Zenkers diveiculum Patients with Zenker diveiculum typically present with upper esophageal dysphagia, regurgitation of undigested food, aspiration, noisy deglutition, halitosis (foul smell from mouth), and/or complaints of changes in their voice. Mild-to-moderate weight loss is frequent. Aspiration and pneumonia are potentially serious complications. Although the diveiculum can reach sizes of 15 cm or more, it is rarely palpable. Squamous cell carcinoma has been found in the diveiculum in less than 0.4-1.5% of specimens. Coexistent hiatus hernia, esophageal spasm, achalasia, and esophagogastroduodenal ulceration are common