A CASE OF A HUGE EPIPHRENIC ESOPHAGEAL DIVERTICULUM

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  • 巨大横隔膜上食道憩室の１例

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Abstract

Esophageal diverticulum is usually asymptomatic and few cases are indicated surgical therapy. This paper presents a surgical case of a huge epiphrenic diverticulum which was detected at a medical checkup and showed an increasing tendency during clinical course, together with some bibliographical comments.<br>A 45-year-old woman, who had been followed for asymptomatic epiphrenic diverticulum detected on an upper gastrointestinal series at a medical checkup, was admitted to the hospital because of an increasing tendency of the diverticulum. Esophagography revealed a 7.5-cm cystic diverticulum on the left wall of the thoracic lower esophagus, when the exudation of contrast material was poor. Upper gastrointestinal endoscopy showed an opening of the diverticulum on the left wall of the lower esophagus, and retention of saburra in the lumen of the diverticulum. Epiphrenic diverticulum was resultantly diagnosed. Because the patient's diverticulum was of pulsion diverticulum with the increasing tendency and poor exudation of its contents, an operation was indicated. Considering the etiolosic mechanisums of pulsion diverticulum, we performed a transabdominal removal of the diverticulum, an extra mucosal excision of tunica muscularis with the diameter of 5cm around the esophagogastric junction, and sutures of the gastric fundus, resulting in uneventful postoperative course.

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