Presentation
Dysphagia and regurgitation.
Patient Data
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.