Diverticula occur more commonly in the thoracic esophagus than in the pharyngoesophageal region. For several reasons, however, more pharyngoesophageal than thoracic diverticula have been treated surgically. Being confined within the limited fascial compartments of the neck, they are more likely than thoracic diverticula to cause symptoms while relatively small. In addition, pharyngoesophageal diverticula are amenable to resection without opening the pleural space. In 1949 Harrington 1 had operated on 216 pharyngoesophageal diverticula and on only 8 thoracic esophageal diverticula. Similarly, Lahey's 2 group by 1954 had removed 365 pharyngoesophageal diverticula and only 9 diverticula from the lower part of the esophagus.
The majority of diverticula in the middle third of the esophagus are of the traction variety. Presumably they result from inflammatory processes in contiguous tissues (for example, trachea, bronchi, and lymph nodes). An attenuated and weakened esophageal wall is dragged outward by consequent scarring and contraction. The neck of
HABEIN HC, MOERSCH HJ, KIRKLIN JW. Diverticula of the Lower Part of the Esophagus: A Clinical Study of One Hundred Forty-Nine Nonsurgical Cases. AMA Arch Intern Med. 1956;97(6):768–777. doi:https://doi.org/10.1001/archinte.1956.00250240120012
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