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Bleeding from an epiphrenic oesophageal diverticulum.
M H Abul-Khair1, A Khalil, A Mohsen
1Department of General Surgery, Faculty of Medicine, Cairo University, Egypt.
The European Journal of Surgery = Acta Chirurgica
|June 1, 1992
Summary
Epiphrenic esophageal diverticulum, a rare condition, can cause dysphagia and bleeding. Surgical removal (diverticulectomy) and myotomy effectively treated a patient with these symptoms.
Area of Science:
- Gastroenterology
- Surgical Gastroenterology
- Esophageal Motility Disorders
Background:
- Epiphrenic esophageal diverticula are rare outpouchings of the esophagus, typically located in the distal esophagus near the diaphragm.
- Symptoms can include dysphagia, regurgitation, chest pain, and, less commonly, bleeding due to ulceration.
- Diagnosis relies on imaging like barium swallow and endoscopy.
Observation:
- A 49-year-old woman presented with a 2-month history of mild dysphagia and three episodes of hematemesis.
- Endoscopy and barium swallow revealed an epiphrenic esophageal diverticulum with an ulcerating crypt.
- No ectopic gastric epithelium was identified within the diverticulum.
Findings:
- The patient was diagnosed with an epiphrenic esophageal diverticulum complicated by ulceration.
- Surgical intervention, specifically diverticulectomy combined with lower esophageal myotomy, was performed.
- The patient experienced a good outcome following the surgical procedure.
Implications:
- This case highlights the successful management of symptomatic epiphrenic diverticula through surgical resection and myotomy.
- It underscores the importance of considering esophageal diverticula in the differential diagnosis of dysphagia and upper gastrointestinal bleeding.
- The absence of ectopic gastric tissue in this case suggests ulceration as the primary cause of bleeding, distinct from other diverticular pathologies.