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Multiple esophageal diverticula

Case contributed by Vikas Shah
Diagnosis certain

Presentation

Elderly man with mild dysphagia.

Patient Data

Age: 75 years
Gender: Male

Barium swallow

Barium

On this barium swallow study, there are multiple outpouchings from the mid and distal esophagus. Barium is seen to pool within the outpouchings. Barium is also seen within the stomach indicating there is no complete obstruction, and the images taken during the swallow indicated no stricture. Some tertiary contractions were seen, indicating a degree of dysmotility. There were no similar outpouchings noted involving the upper esophagus.

Case Discussion

This is a case of multiple esophageal diverticula. In the mid esophagus, these are divided into true and false diverticula: true diverticula are secondary to traction from outside the esophagus which creates a pulling force on the wall (for example, in scarring and fibrosis in the mediastinum from old TB); and false diverticula which are secondary to raised intraluminal pressures and are also named pulsion diverticula. This particular case was one of multiple false or pulsion esophageal diverticula.

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