Management of huge epiphrenic esophageal diverticula

Donald G. Mulder, Eliot Rosenkranz, Lawrence DenBesten

Research output: Contribution to journalArticlepeer-review

17 Scopus citations

Abstract

Epiphrenic diverticula occur in association with motor disorders of the distal esophagus, including achalasia and diffuse esophageal spasm. Four patients with huge symptomatic epiphrenic diverticula are presented to emphasize the need for complete radiographic and manometric studies of the esophagus to document this motor dysfunction prior to performing combined diverticulectomy and esophagomyotomy. Each patient had achalasia with symptoms extending from 4 to 25 years. Diverticulectomy and esophagomyotomy were performed in every patient. One patient had previously undergone diverticulectomy alone, with prompt recurrence of the lesion. During a follow-up period extending from 2 to 10 years, three patients were alive and well. One patient developed recurrent dysphagia due to reflux esophagitis and stricture requiring dilatation. It is essential that esophagomyotomy be part of the initial operative procedure. In selected patients, an antireflux procedure may also be indicated.

Original languageEnglish (US)
Pages (from-to)303-307
Number of pages5
JournalThe American Journal of Surgery
Volume157
Issue number3
DOIs
StatePublished - Mar 1989
Externally publishedYes

ASJC Scopus subject areas

  • Surgery

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