OBJECTIVES: 1. To present a case of a patient with a large epiphrenic diverticulum manifesting as esophageal obstruction. 2. To consider esophageal diverticula as a differential diagnosis of esophageal malignancy. 3. To discuss the clinical presentation, diagnosis, and management of epiphrenic diverticula.
SETTING: A tertiary care university hospital
CASE SUMMARY: Epiphrenic diverticula are rare, and located within 10 cm. from the gastroesophageal junction. These usually arise as result of esophageal motility disorders. A 71 year-old female presented with progressive dysphagia for solids and liquids with subsequent esophageal obstruction. Esophageal malignancy was suspected, but a large epiphrenic diverticulum was diagnosed with a barium esophagogram and esophagoscopy. She underwent left thoracotomy, with diverticulectomy, esophageal myotomy, and fundoplication. She had resolution of her symptoms post-operatively. Esophageal diverticula should always be considered in patients presenting with dysphagia. Only symptomatic patients require surgery.