Year 2023 / Volume 115 / Number 12
Letter
Large symptomatic esophageal diverticulum

725-726

DOI: 10.17235/reed.2023.9518/2023

José Antonio Aguirre Sánchez-Cambronero, David Rodríguez-Bobada Caraballo, Carlos Martínez Flores, Natividad Sánchez-Manjavacas Muñoz,

Abstract
A 72-year-old woman was referred from primary care to the gastroenterology clinic because of heartburn and occasional dysphagia for the last 8 years, with some isolated food regurgitation events and no other warning signs; she is currently asymptomatic on omeprazole. Gastroscopy revealed a dilated esophagus and food remnants with inability to reach the gastric lumen, which led to the suspicion of achalasia. The study was completed with pH-metry, which found no pathological reflux; esophageal manometry, with absence of esophageal motor abnormalities; and barium swallow, which revealed a large diverticulum on the posterior wall of the lower third of the esophagus, which had food remnants but no other changes or evidence of achalasia. Given these findings, a repeat gastroscopy was carried out that revealed a large diverticulum in the distal third of the esophagus that occluded 50 % of the esophageal lumen, with a length of 4-5 cm and abundant semi-liquid food remnants; upon aspiration of the latter a whitish mucosa with erythematous areas was revealed, as well as a 1.5-cm sliding hiatal hernia. No changes were found on advancing to the second duodenal portion. In view of the above findings and symptoms, the patient was referred to the surgery department to be evaluated for diverticulectomy.
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References
1. Argüelles Estrada, P.; Fernández Cadenas, F.; Giganto Tomé, F.; et al. (2022) “Over-the-scope clip closure of an acquired bronchoesophageal fistula secondary to an esophageal diverticulum,” Revista Española de Enfermedades Digestivas 2022. DOI: 10.17235/reed.2022.9176/2022. Available at: https://doi.org/10.17235/reed.2022.9176/2022.
2. Díaz-Alcázar, M.M; Ruiz-Escolano, E; Ruiz-Rodríguez, A. J. 2018. Diverticulos medioesofágicos: de incidentaloma esofágico a causa poco habitual de disfagia. Revista Andaluza de Patología Digestiva. RAPD. This article is available from https://www.sapd.es/revista/2018/41/6/08
3. Soares, R. Herbella, F; Prachand, V; et al. 2010. Epiphrenic diverticulum of the esophagus. from pathophysiology to treatment. Journal of Gastrointestinal Surgery, 14(12), pp. 2009–2015. Available at: https://doi.org/10.1007/s11605-010-1216-9.
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Citation tools
Aguirre Sánchez-Cambronero J, Rodríguez-Bobada Caraballo D, Martínez Flores C, Sánchez-Manjavacas Muñoz N. Large symptomatic esophageal diverticulum. 9518/2023


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Publication history

Received: 09/02/2023

Accepted: 21/02/2023

Online First: 10/03/2023

Published: 12/12/2023

Article Online First time: 29 days

Article editing time: 306 days


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