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Esophageal epiphrenic diverticulum associated with diffuse esophageal spasm.
Hideo Matsumoto1, Hisako Kubota1, Masaharu Higashida1
1Departments of Digestive Surgery, Kawasaki Medical School, Kurashiki, Okayama, Japan.
International Journal of Surgery Case Reports
|July 6, 2015
Summary
Esophageal epiphrenic diverticulum can be associated with diffuse esophageal spasm, a condition that may not be initially identified. This case highlights the importance of considering motility disorders in recurrent dysphagia after diverticulum treatment.
Area of Science:
- Gastroenterology
- Esophageal Disorders
- Surgical Case Reports
Background:
- Esophageal diverticulum is a rare condition often linked to esophageal motor abnormalities.
- Coordination issues between the distal esophagus and lower esophageal sphincter are implicated.
Purpose of the Study:
- To report a case of esophageal epiphrenic diverticulum associated with diffuse esophageal spasm.
- To discuss the diagnostic challenges and management of such cases.
Main Methods:
- Case presentation of a 73-year-old woman with dysphagia and regurgitation.
- Diagnostic workup included imaging, high-resolution manometry, and 24-h pH monitoring.
- Surgical resection of the diverticulum via thoracoscopy.
Main Results:
- Initial high-resolution manometry showed normal esophageal motility.
- 24-h pH monitoring revealed continuous acidity due to diverticular residue.
- Recurrent dysphagia 2 years post-surgery was diagnosed as diffuse esophageal spasm via high-resolution manometry.
Conclusions:
- The esophageal diverticulum was associated with diffuse esophageal spasm, which was likely missed in the initial evaluation.
- While symptoms resolved spontaneously in this case, long-term follow-up is crucial.
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