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Clinical Problem Solving
July 2014

A Patient With Cough and Dysphagia

Author Affiliations
  • 1University of California, Irvine
JAMA Otolaryngol Head Neck Surg. 2014;140(7):673-674. doi:10.1001/jamaoto.2014.670

A woman in her 60s with no clinically significant medical history presented with a several-month history of coughing and food getting stuck in her throat after eating. The patient denied food regurgitation, respiratory difficulties, history of aspiration pneumonia, or weight loss. No abnormalities were noted on physical examination of the head and neck or on flexible laryngoscopy. A gastroenterologist had previously performed an esophagoscopy, findings of which were significant for an esophageal pouch and preliminary diagnosis of Zenker diverticulum. Barium swallow was performed, and lateral and anteroposterior views are shown in Figure, A and B, respectively. The patient desired surgical treatment for this lesion. In the operating room, rigid esophagoscopy was performed. The cricopharyngeus muscle was noted, and a lateral pouch was identified (Figure, C).

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