Dear Editor, Zenker’s diverticulum (ZD) is a pulsin type diverticulum of the hypopharynx caused by the elevation of pressure within the esophagus and herniation of the esophageal mucosa and submucosa.1 The peak incidence of this disease is in the seventh to ninth decades and diagnosis is more common in men and elderly patients. The highest prevalence rate is estimated at 2 per 100, 000 people.1, 2 Hiatal hernia and/or gastroesophageal reflux disorder (GERD), male gender and age are risk factors for development of Zenker’s diverticulum.2 The patients usually present with dysphagia, halitosis, regurgitation, postprandial emesis, chronic cough, aspiration, and/or weight loss. Diagnosis is based on clinical symptoms and confirmed by barium esophagaram.3 Our patient is a 44-year-old man presented with regurgitation, undigested food, halitosis, and on and off dysphagia. Barium swallow showed bisegment diverticulum in posterior part of cervical esophagus with a single neck at the level of C7-T1. Findings were in favor of Zenker’s diverticulum (Figure 1). Bicornuate Zenker’s diverticulum was confirmed by exploration of left side of neck (Figure 2). Diverticulectomy and long segment myotomy were performed. Post operation period was clear.

Introduction: Zenker's diverticulum is an acquired sac-like outpouching of the mucosa and submucosa layers originating at the pharyngoesophageal junction. The predominant symptom of Zenker’, s diverticulum is dysphagia. Videofluoroscopy confirms the diagnosis. Forestier disease is a clinical entity characterized by ossification of anterolateral vertebral ligament and anterior osteophyte formation along the anterolateral spinal column. Its etiopathogenesis remains unknown and common symptoms are dysphagia, dysphonia and airway obstruction. The objective of this study is to identify a pathophysiological correlation between Forestier disease and the onset of Zenker’, s diverticulum. Materials and Methods: A retrospective observational study was conducted. The electronic database of our Radiology Unit was analyzed in order to identify patients with hypopharyngeal diverticulum and osteophytes at the cervical vertebrae level, from January 2010 to January 2021. The search was performed using precise keywords. Results: The computerized database search outlined 10 imaging exams: 5 videofluorographies and 5 computed tomography scans. In 100% of the cases, dysphagia was the main symptom that led to the diagnostic assessment,30% of patients, on the other hand, reported dyspnoea. From the data analysis, the male / female ratio is 1: 1 and the average age of the patients is 64. 8 (+/-11. 31) years. Conclusions: We assume that the anatomical abnormalities in Forestier disease may cause an increase of pharyngeal pressure and consequently support the development of the Zenker’, s diverticulum. Hence, it is always recommended to investigate the presence of Zenker’, s diverticulum in a patient with Forestier disease, especially for the lifethreatening complications of Zenker's diverticulum.

Meckel’s diverticulum (MD) is a congenital outpouching or bulge in the lower part of the small intestine. It is the most common congenital defect of the gastrointestinal tract. MD is usually asymptomatic but when symptomatic, typically presents in childhood. A case is presented of a 33-year-old Caucasian man who presented with multiple episodes of bright red blood per rectum prior to hospital admission, with associated weakness and nausea. The patient denied abdominal discomfort, fevers, or vomiting. Eventually, it was found that the patient had a Meckel’s diverticulum with an associated focus of active extravasation from a dilated mesenteric vein. The feeding artery was successfully embolized with cessation of flow to the draining vein. Colonoscopy and computed tomography (CT) scan were inconclusive, and the patient ultimately underwent diagnostic laparoscopy and small bowel resection of the Meckel’s diverticulum to prevent further bleeding by removing aberrant tissue