Dysphagia

, Volume 21, Issue 3, pp 198–205

Esophageal Diverticula: Pathogenesis, Clinical Aspects, and Natural History

  • Fernando Antonio Pinto do Nascimento
  • Eponina M. Oliveira Lemme
  • Milton M.B.Costa
Article

DOI: 10.1007/s00455-006-9028-5

Cite this article as:
Nascimento, F.A.P.., Lemme, E.M.O. & M.B.Costa, M. Dysphagia (2006) 21: 198. doi:10.1007/s00455-006-9028-5

Abstract

It has been gradually accepted that esophageal diverticula result from esophageal motor disorders rather than from primary anatomic abnormalities. Twenty-seven patients with these diverticula were evaluated with respect to pathogenesis, clinical aspects, diagnostic tests, therapy, and natural history for a mean of 27 months of followup. Thirteen diverticula were midesophageal, 11 were situated in the distal third of the esophagus, and 3 were in both regions. Esophageal dysmotility was observed in 85% of patients. Specific esophageal motor disorders were more frequent in association with diverticula of the distal third than in midesophageal diverticula, suggesting that they result from a pulsion mechanism. Traction was the possible mechanism in 27% of midesophageal diverticula. Endoscopic esophagitis was seen in one patient and abnormal acid reflux in 25% of the cases, mainly in patients with distal diverticula. Distal diverticula presented with more severe symptoms than did midesophageal diverticula, and 27% of those required surgical treatment. Patients with midesophageal diverticula seem to have a better prognosis than those with more distal disease.

Key words

Esophageal diverticulaEsophageal motor disordersGastroesophageal reflux disease

Copyright information

© Springer Science+Business Media, Inc. 2006

Authors and Affiliations

  • Fernando Antonio Pinto do Nascimento
    • 1
  • Eponina M. Oliveira Lemme
    • 1
    • 2
  • Milton M.B.Costa
    • 1
  1. 1.Division of GastroenterologyClementino Fraga Filho University Hospital, Federal University of Rio de Janeiro Medical SchoolRio de JaneiroBrazil
  2. 2.Rio de JaneiroBrasil