Internal Laryngocele and Zenker's Diverticulum Masquerading as a Laryngeal Fracture and Esophageal Perforation and Rupture

Internal Laryngocele and Zenker’s Diverticulum Masquerading as a Laryngeal Fracture and Esophageal Perforation and Rupture

We present an interesting case of concomitant laryngocele and Zenker’s diverticulum found incidentally after sustained blunt anterior neck trauma. Our service was consulted to evaluate free air on a CT scan in the paralaryngeal space and also the paraesophageal area of the cervical esophagus. The trauma surgery service had concern for laryngeal fracture and esophageal rupture. The patient’s lack of complaint except for a very stiff neck and failure to reveal abnormal findings on a complete head and neck exam, in addition to detecting no abnormal findings on flexible laryngoscopy, alluded that this air seen on the initial CT scan was not due to the injury. The formal CT scan of the larynx and trachea in addition to esophagram led us to a diagnosis of simultaneous laryngocele and Zenker’s diverticulum. This is a very unusual coincidental diagnosis; however it still raises the importance for maintaining a high level of suspicion and due diligence in assessing the upper aerodigestive tract in blunt anterior neck trauma.