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Delayed primary repair of perforated epiphrenic diverticulum
Ju-Hyeon Lee1, Hiun-Suk Chae, Kwan-Hyoung Kim
1Department of Cardiothoracic Surgery, The Catholic University of Korea, College of Medicine, Seoul, Korea.
Journal of Korean Medical Science
|December 21, 2004
Summary
A perforated epiphrenic esophageal diverticulum caused chest pain. Delayed primary repair and conservative management successfully treated the esophageal leakage.
Area of Science:
- Gastroenterology
- Surgical Gastroenterology
- Esophageal Surgery
Background:
- Epiphrenic diverticula are rare outpouchings of the esophagus.
- Perforation of these diverticula is a serious complication requiring prompt management.
- Sudden chest pain postprandially can indicate esophageal emergencies.
Observation:
- A 68-year-old male presented with acute postprandial chest pain.
- Diagnostic imaging revealed a perforated epiphrenic diverticulum with esophageal leakage.
- Initial urgent primary repair was performed.
Findings:
- Postoperative imaging showed a small, contained esophageal leak 14 days after surgery.
- Conservative management, including intravenous hyperalimentation and antibiotics, was initiated.
- Complete resolution of the esophageal leak was confirmed 42 days post-operation.
Implications:
- This case highlights the successful application of delayed primary repair for perforated epiphrenic diverticula.
- Conservative management can be effective for contained esophageal leaks post-repair.
- This represents the first reported case of delayed primary repair for this condition in Korea.