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Related Concept Videos

Esophageal Achalasia01:27

Esophageal Achalasia

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Esophageal achalasia is a chronic neurogenic disorder characterized by impaired relaxation of the lower esophageal sphincter (LES) and absent or ineffective peristalsis in the distal esophagus. This leads to a functional obstruction without a physical blockage, despite significant disruption of esophageal motility.EtiologyAchalasia is caused by degeneration of the myenteric (Auerbach's) plexus, specifically the loss of inhibitory ganglion cells that produce vasoactive intestinal peptide...
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Hiatal Hernia01:25

Hiatal Hernia

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A hiatal hernia is the abnormal protrusion of the stomach or other abdominal organs through the esophageal hiatus of the diaphragm into the thoracic cavity.Normally, the gastroesophageal junction (GEJ) lies below the diaphragm and is supported by the phrenoesophageal membrane, the diaphragmatic crura, and connective tissues. Weakening of these structures—due to aging, congenital defects like a short esophagus, or increased intra-abdominal pressure from coughing, obesity, pregnancy, or...
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Diverticular Disease of the Colon01:27

Diverticular Disease of the Colon

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Diverticular disease involves the formation of diverticula—small sac-like outpouchings of the colonic wall—and their complications. It most commonly affects the sigmoid colon due to higher intraluminal pressure and structural vulnerability. It results from structural weakness and increased pressure in the colon, producing pseudodiverticula that may remain silent or progress to inflammation and serious complications.Structure of DiverticulaIn diverticulosis, these outpouchings are...
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Gastroesophageal Reflux Disease01:25

Gastroesophageal Reflux Disease

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Gastroesophageal reflux disease (GERD) is the backward flow of stomach contents (acid, pepsin, or bile) into the esophagus, causing mucosal inflammation known as esophagitis. It results from failure of antireflux mechanisms, mainly the lower esophageal sphincter (LES), influenced by mechanical and physiological factors.Etiology and Risk FactorsGERD develops when LES function is weakened or when intra-abdominal pressure increases. Risk factors include aging, obesity, and sliding hiatal hernia,...
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Esophageal Strictures-II: Clinical Features and Management01:26

Esophageal Strictures-II: Clinical Features and Management

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Patients with esophageal strictures often experience a range of symptoms. Initially, they may have difficulty swallowing solid foods, which can progress to include liquids. Additional symptoms may involve chest pain or discomfort, regurgitating food and fluids, heartburn, unintentional weight loss, coughing or choking during meals, and hoarseness.
Healthcare providers should gather a comprehensive medical history and conduct a physical examination for diagnosis. If esophageal stricture is...
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Esophageal Strictures-I: Introduction01:30

Esophageal Strictures-I: Introduction

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Esophageal strictures involve abnormal narrowing or tightening of the esophagus. They vary in length and severity, ranging from mild constriction to complete obstruction, and are classified as benign (noncancerous) or malignant (cancerous).
Etiology
The primary cause of esophageal strictures is long-standing gastroesophageal reflux disease (GERD), accounting for about 70 to 80% of adult cases. Chronic acid reflux can lead to injury and scarring of the esophageal lining, culminating in...
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Updated: Apr 18, 2026

Robotic Myotomy and Partial Fundoplication for Achalasia
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Achalasia and epiphrenic diverticulum.

P Marco Fisichella1, Anahita Jalilvand, Adrian Dobrowolsky

  • 1Department of Surgery, Brigham and Women's Hospital and Boston VA Healthcare System, Harvard Medical School, Boston, MA, USA, piero.fisichella@va.gov.

World Journal of Surgery
|January 23, 2015
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Summary

Epiphrenic diverticula, often linked to esophageal motility disorders like achalasia, require integrated treatment. Managing the underlying condition is crucial for preventing complications and recurrence after surgery.

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Area of Science:

  • Gastroenterology
  • Surgical Gastroenterology
  • Esophageal Diseases

Background:

  • Epiphrenic diverticula are rare esophageal outpouchings.
  • They are strongly associated with underlying esophageal motility disorders, most commonly achalasia.

Purpose of the Study:

  • To detail the pathophysiology, clinical presentation, diagnosis, and treatment of epiphrenic diverticula.
  • To provide an overview of surgical management, including indications and approach selection.

Main Methods:

  • Literature review and synthesis of current knowledge on epiphrenic diverticula.
  • Analysis of diagnostic modalities and surgical techniques.

Main Results:

  • Integrated management of the underlying motility disorder is essential for successful treatment.
  • Symptomatic patients generally benefit from surgical intervention, with approach tailored to diverticulum characteristics.
  • Performing myotomy concurrently with diverticulectomy may reduce postoperative morbidity.

Conclusions:

  • Effective management of epiphrenic diverticula necessitates addressing associated esophageal motility disorders.
  • Surgical approach selection is critical for optimal outcomes in symptomatic patients.
  • The risk of carcinoma is very low, and surveillance is not recommended for asymptomatic cases.