Combined double-endoscopic surgery for a giant left-sided supradiaphragmatic esophageal diverticulum: a case report

Esophageal diverticulum is a rare condition, with supradiaphragmatic esophageal diverticula being even rarer, occurring in only approximately 0.06%-4% of cases, and most of these are located on the right side of the esophagus. This article reports a rare case of a giant left-sided supradiaphragmatic esophageal diverticulum, aiming to explore its diagnostic methods, surgical strategies, and therapeutic outcomes, thereby providing a reference for similar complex cases.

A 58-year-old male patient was found to have an esophageal diverticulum during a physical examination 3 months ago, which was prompted by long-term symptoms of acid reflux and heartburn. Gastroscopy revealed that the diverticulum was located 38 cm from the incisors, and computed tomography (CT) and barium meal radiography confirmed a left lower thoracic esophageal diverticulum measuring approximately 70 ×55 mm. The patient had long been troubled by acid reflux and heartburn. After undergoing surgery at our hospital, the patient recovered well, with no postoperative complications.

Thoracic esophageal diverticula are most commonly caused by esophageal motility disorders, with left-sided occurrence being particularly rare. Diagnosis requires a comprehensive assessment combining gastroscopy, CT, and barium meal radiography, and the differential diagnosis should exclude conditions such as hiatal hernia. The combined double-endoscopic technique offers the advantages of minimally invasive surgery and precise operation, effectively reducing injury to the esophageal muscle layer and postoperative complications.

This case demonstrates that combined double-endoscopic surgery is a preferred, safe, effective, and minimally invasive option for the treatment of giant or complex esophageal diverticula, and it holds significant value for clinical application.