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Related Experiment Videos

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
PubMed
Summary
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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.

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  • 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.