Endoscopy 2018; 50(04): S140
DOI: 10.1055/s-0038-1637451
ESGE Days 2018 ePosters
Georg Thieme Verlag KG Stuttgart · New York

A RARE CASE OF OESOPHAGUS DIVERTICULUM

P Golovics
1   Medical Centre, Hungarian Defence Forces, Department of Gastroenterology, Budapest, Hungary
,
K Rabai
1   Medical Centre, Hungarian Defence Forces, Department of Gastroenterology, Budapest, Hungary
,
E Molnar
1   Medical Centre, Hungarian Defence Forces, Department of Gastroenterology, Budapest, Hungary
,
F Zsigmond
1   Medical Centre, Hungarian Defence Forces, Department of Gastroenterology, Budapest, Hungary
,
L Herszenyi
1   Medical Centre, Hungarian Defence Forces, Department of Gastroenterology, Budapest, Hungary
› Author Affiliations
Further Information

Publication History

Publication Date:
27 March 2018 (online)

 

Aims:

A 81-year-old male patient was admitted to the tercier center gastroenterology department. His complains were dysphagia, epigastrial pain, vomiting and food regurgitation. During the 2-month-long complains there was no bleeding or weight loss. The patient was medically treated due to reflux in the past 20 years by the GP. In his medical history, he had an operation and received hormonal injection therapy due to prostate cancer.

Our aim was to establish the diagnosis and find the appropriate treatment for the patient. Due to his age, our differential diagnoses included reflux, achalasia due to severe reflux or malignant tumor.

Methods:

Gastroscopy under x-ray was performed. After the administration of the contrast material we saw a 12 × 8 cm big epiphrenic diverticulum. Due to the first idea we closed out the achalasia or the achalasia caused diverticulum with the expander. There was no reacting force. The next day swallowing x-ray confirmed the diverticulum with adequate passage.

Results:

We consulted with a thoracic-surgeon, who suggested conservative therapy. The patient was supplied with dietary advice. After consumption of soft food the patient complains decreased. After the diagnosis we re-estimated the patient previous chest x-rays and since 2014 there was a sign of the diverticulum, but all the records described it as a bigger stomach-air. The estimated incidence of the epiphrenic esophageal diverticula (EED) is about 1:500,000/year. The cause of the EED is a combination of esophageal obstruction and weakness of the muscular propria.

Conclusions:

This case highlights the importance of the re-evaluation of the earlier radiological findings and calls the attention to remember the rare diseases.