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Case Reports
. 2024 May 29;2024(5):rjae316.
doi: 10.1093/jscr/rjae316. eCollection 2024 May.

Atypical presentation of an epiphrenic esophageal diverticulum 20 years post fundoplication: a case report and review

Dana Tasabehji  1 , Mohammad Jarrah  1 , Mohamad Mokadem  1   2   3
Affiliations
Case Reports

Atypical presentation of an epiphrenic esophageal diverticulum 20 years post fundoplication: a case report and review

Dana Tasabehji et al. J Surg Case Rep. .

Abstract

Esophageal diverticulum is a rare condition characterized by the herniation of the esophageal mucosa outside the esophageal wall. Here, we explore the prevalence of ED and its associated esophageal dysmotility. We also shed light on the potential impact of previous surgical interventions, such as Nissen's fundoplication, on the development of ED. This manuscript presents the case of a 72-year-old woman with a history of Nissen's fundoplication surgery who experienced worsening symptoms of dysphagia, heartburn and postprandial cough. Despite exhibiting a normal motility pattern, upper endoscopy revealed a large epiphrenic esophageal diverticulum. The patient underwent successful surgical resection with myotomy, resulting in the resolution of symptoms with no complications. This case highlights the rarity of symptomatic ED and the need to recognize it while choosing the optimal treatment modality.

Keywords: diverticulectomy; epiphrenic diverticulum; esophageal diverticulum; myotomy.

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Conflict of interest statement

None declared.

Figures

Figure 1
Figure 1
Large epiphrenic ED visualized on upper endoscopy.
Figure 2
Figure 2
X-ray esophagram fluoroscopy showing a 6.0 × 5.0 cm epiphrenic ED with a 3.3 cm neck.
Figure 3
Figure 3
Normal motility pattern on high-resolution manometry test in a patient with epiphrenic ED.
Figure 4
Figure 4
Normal X-ray esophagram fluoroscopy postdiverticulectomy with myotomy surgery.
See this image and copyright information in PMC

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