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Profuse bleeding in epiphrenic diverticula: an unusual finding

D A Hoxie1, M C Dillon, W B Tuckson

  • 1Howard University Hospital, Washington, DC, USA.

Journal of the National Medical Association
|May 1, 1995
PubMed
Summary
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This case report details a rare instance of severe esophageal bleeding caused by an ulcer within epiphrenic diverticula. Reduced alcohol and tobacco use led to the cessation of bleeding episodes.

Area of Science:

  • Gastroenterology
  • Esophageal Diseases
  • Surgical Case Reports

Background:

  • Epiphrenic diverticula are rare outpouchings of the esophagus.
  • Profuse bleeding is an uncommon complication of epiphrenic diverticula.
  • Alcohol and tobacco abuse are known risk factors for various gastrointestinal conditions.

Observation:

  • A patient with a history of alcohol and tobacco abuse presented with significant hematemesis.
  • Endoscopic and radiographic evaluations revealed epiphrenic diverticula and a bleeding ulcer.
  • Biopsies showed evidence of candida esophagitis.

Findings:

  • A large, bleeding ulcer was identified within the distal esophagus, associated with epiphrenic diverticula.
  • Hypertensive lower esophageal pressure was noted on manometry.

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  • The patient's bleeding resolved after reducing alcohol and tobacco intake.

    • Implications:

    • This case highlights a previously unreported cause of massive upper gastrointestinal bleeding.
    • Conservative management, including lifestyle modification, may be effective in managing bleeding epiphrenic diverticula.
    • Further research is needed to understand the relationship between epiphrenic diverticula, ulcers, and esophageal pressure.