Mid-esophageal traction diverticulum: rare cause of massive upper gastrointestinal bleeding

Traction diverticula of the mid-esophagus are usually incidental findings on barium swallow or upper endoscopy. They are thought to arise secondary to adjacent inflammation in the mediastinum, usually from granulomatous infection such as histoplasmosis. They are usually asymptomatic. Rarely, erosion or extension of the inflammatory process into the adjacent lung or bronchial arteries can result in clinical symptoms such as pneumonia or gastrointestinal bleeding. Diagnosis is often delayed due to the rarity of clinical symptoms. We present a case of massive upper gastrointestinal bleeding due to a mid-esophageal diverticulum.