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 24 April 2018

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Esophageal diverticulum.
A 49-year old with a two-year history of dysphagia. At the time of presentation it was taking him 20 minutes to eat a sandwich. The contrast study shows a large diverticulum at the lower end of the esophagus. It contains food residue. These findings were confirmed endoscopically. Manometric studies were attempted, but the catheter assembly could not be passed distal to the diverticulum. The upper esophageal sphincter functioned normally.

Most of these epiphrenic diverticula are thought to be pulsion diverticula which have arisen secondary to a motility disorder of the esophagus. Many are asymptomatic and the patient tends to present with problems related to the underlying motility disorder - as in the present case, who had achalasia. Left untreated, esophageal diverticula may be complicated by recurrent inflammation, fistula formation and malignancy. Preferred treatment is excision of the diverticulum and cardiomyotomy.


Peter Devitt, Adelaide, Australia

Esophageal diverticulum.

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