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The Killian–Jamieson space is a triangular area of weakness in the upper anterolateral cervical esophagus, not to be confused with Killian’s dehiscence. The Killian–Jamieson space is bounded superiorly by the inferior border of the cricopharyngeus, anteriorly by the cricoid cartilage, and inferomedially by the suspensory ligament of the esophagus [35]. Transient protrusions through the Killian–Jamieson space are called lateral proximal cervical esophageal pouches, whereas persistent protrusions are called lateral proximal cervical esophageal diverticula. These structures are also known as Killian–Jamieson pouches and diverticula, respectively [36].

Killian–Jamieson diverticula, which are about one‐third as common as Zenker’s diverticula, have a characteristic radiographic appearance [36]. They are either unilateral, usually on the left, or bilateral [6]. The diverticula appear on barium studies as persistent 3–20 mm outpouchings with distinct necks (Figure 6.15). The diverticula extend lateral to the cervical esophagus on frontal views and overlap the cervical esophagus on lateral views. In contrast, a Zenker’s diverticulum is in the midline on frontal views and posterior to the cervical esophagus on lateral views (Figure 6.16). When barium is regurgitated from Killian–Jamieson diverticula, it enters the cervical esophagus because the diverticula are below the cricopharyngeal muscle. Thus, there is a lower risk of aspiration from Killian–Jamieson diverticula than from Zenker’s diverticula. Killian–Jamieson pouches appear as small, transient outpouchings just below the closing cricopharyngeus muscle and are usually detected near the end of swallowing or after the bolus has passed through the cervical esophagus.

Figure 6.13 Incomplete opening of the cricopharyngeus. (A) Lateral view of the pharynx obtained just as the bolus (e) is entering the hypopharynx. (B) Lateral view of the pharynx at the end of bolus passage. The cricopharyngeus (long white arrow) is closing before the bolus has cleared the hypopharynx. The posterior pharyngeal contraction wave is identified (thick white arrow). A jet of barium (black arrow) spurts through the anterior wall of the cervical esophagus.