Zenker’s diverticulum is a rare disease, with an annual incidence of about 2 cases per 100000, occurring
most often in elderly men. No data are reported in dialysis patients. We report a case of a hemodialysis
patient who experienced a sudden spontaneous perforation of an unknown esophageal diverticulum. To our
knowledge, this is the first case reported in a hemodialysis patient. Its description could be helpful to
consider in such patients the possibility of the perforation of an esophageal diverticulum when typical
symptoms are referred in addition to the exclusion of other events with similar symptoms (acute esophagitis
and gastroduodenitis, perforated peptic ulcer, acute pancreatitis, myocardial infarction, pneumothorax,
dissecting aortic aneurysm).