Linda Gage-White, MD, and Brian F. McCabe, MD, reported the experience of the University of Iowa Hospitals (Iowa City) with patients with concomitant occurrence of Zenker's diverticulum and hiatal hernia. Their retrospective review, which spanned a 40-year period, was presented at the Middle Section meeting of the Triological Society, Ann Arbor, Mich. Their research identified 104 patients who were noted to have both of these esophageal abnormalities. Male and female patients were equally affected in their study. The authors were able to identify an increased incidence of hiatal hernia in patients with Zenker's diverticulum, when compared with a control group of patients who underwent a barium swallow as part of a workup for head and neck malignancy. In the control group, the incidence of finding coincidental Zenker's diverticulum and hiatal hernia was 51%. Hiatal hernia was present in 38.5% of the patients with Zenker's diverticulum. The mechanism to explain this