Epiphrenic diverticulum

Case contributed by Mohammad Taghi Niknejad
Diagnosis certain

Presentation

Dysphagia and regurgitation.

Patient Data

Age: 60 years
Gender: Male
Fluoroscopy

A 55 mm well-defined smooth-margin outpouching in the distal oesophagus just before the lower oesophagal sphincter inferring epiphrenic diverticulum.

A small-sized sliding hiatal hernia is also present.

Case Discussion

Epiphrenic diverticula are pulsion diverticula of the distal oesophagus, less frequent than traction mid-oesophageal diverticula. They are usually seen on the right posterolateral wall arising just above the lower oesophageal sphincter, and when large they can cause distal oesophageal compression, dysphagia and regurgitation. A single contrast oesophagogram, including prone right anterior oblique views of the distal oesophagus, is the best imaging method for diagnosis.

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