Management of minimally symptomatic pulsion diverticula of the esophagus

Abstract

Diverticula of the esophageal body are protrusions or outpouchings of the esophageal lumen. They are usually classified according to their anatomical relationship with the esophagus and/or mechanism of formation: diverticula originating close to the middle third of the esophagus, 4 to 5 cm from the carina, are defined as midthoracic or parabronchial diverticula; diverticula close to the diaphragm are named epiphrenic diverticula. Midthoracic diverticula have been seen as the consequence of chronic inflammatory processes starting from the mediastinal lymph nodes (usually from granulomatous disease, as in tuberculosis) and involving the esophageal wall; they have also been called traction diverticula, according to Rokitansky. An abnormal esophageal motility, generating high intraluminal pressures in short segments of the gullet, with or without esophageal wall weakness, can lead to mucosal herniation and the development of pulsion diverticula. © 2007 Springer-Verlag London Limited.