食道憩室是相對少見的食道結構疾病，患者會有吞嚥困難、食團噎住異物感、胃食道逆流、口臭、慢性咳嗽等症狀，甚至可能發生反覆性肺炎、體重減輕、出血。部分患者則是由內視鏡意外發現，無明顯臨床表徵。食道憩室依照其分布位置分為上食道憩室（Zenker's diverticulum）、中食道憩室（Rokitansky diverticulum）、下食道憩室（Epiphrenic diverticulum），對照分布位置有不同的形成機轉。上段食道憩室之形成機轉被認為是上食道括約肌的組織纖維變性導致彈性下降，使得食團在通過相對薄弱區域形成的推進型憩室；中段食道憩室被認為是相鄰結構發炎造成的牽引型憩室，但亦有研究說明其可能為食道運動異常造成的推進型憩室；下段食道憩室則被許多研究證實可能為食道運動異常造成的推進型憩室。臨床上，過往常被用來評估食道憩室之檢查為內視鏡、食道鋇劑攝影及電腦斷層，主要用以評估食道憩室位置大小、檢視結構性病灶及可能的食道運動異常。近年來，隨著高解析度食道壓力檢查（High resolution manometry, HRM）的臨床應用日漸普及，再加上最新芝加哥分類（Chicago Classification）對食道運動異常描述更為精確，有助於了解形成食道憩室之病態生理學及擬定進一步之治療策略。在治療方面，食道憩室因不同分布位置及不同機轉而有其對應的治療策略。傳統上，上食道憩室的治療為外科開刀手術與內視鏡切除，最近研究結果顯示內視鏡憩室切除術有更低的併發症，適合年老或多共病症族群；中食道憩室與下食道憩室治療策略相似，近年之代表性數據庫分析之結果顯示腹腔鏡手術併發症遠低於開胸手術。最新發展出來的經口內視鏡肌肉切開術（Peroral endoscopic myotomy, POEM），以其極高臨床改善率及較低併發症，目前已漸普遍應用在上食道憩室及下食道憩室患者，值得期待。

Esophageal diverticulum is an uncommon structural disorder that manifests as dysphagia, esophageal stuck sensation, foul breath, acid reflux, heartburn, chronic cough, and has been related to recurrent pneumonia, bleeding and esophageal cancer. Some asymptomatic patients are found accidentally on endoscopy. The pathophysiology of esophageal diverticulum varies based on its location of the esophagus. Zenker's diverticulum is associated with impaired upper esophageal sphincter relaxation, while middle esophageal diverticulum is related to traction or pulsion. Epiphrenic diverticulum is mostly related to pulsive factors and esophageal dysmotility. Diagnosis of esophageal diverticulum include an upper endoscopy, barium esophagography, computed tomography, and high-resolution manometry (HRM). HRM helps to clarify potential esophageal motility abnormalities underlying the esophageal diverticulum, which may affect the treatment strategy. Traditionally, Zenker diverticulum is treated with surgical or endoscopic treatment, and the latter is suitable for the elderly and patients with multiple comorbidities for its lower complication rates. The treatment strategy of pulsive Rokitansky diverticulum and epiphrenic diverticulum are similar. Laparoscopic approach is associated with lower complication rates than thoracotomy. Recently, the efficacy and safety of peroral endoscopic myotomy (POEM) have been demonstrated in the management of Zenker's diverticulum and epiphrenic diverticulum. More long-term follow-up studies are awaited.