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World Journal of Surgery

, Volume 39, Issue 7, pp 1620–1624 | Cite as

Achalasia and Epiphrenic Diverticulum

  • Fernando A. M. Herbella
  • Marco G. Patti
Surgical Symposium Contribution

Abstract

Esophageal epiphrenic diverticulum (EED) is a pseudodiverticulum of pulsion type located in the distal 10 cm of the esophagus and frequently associated to achalasia. The symptoms and the pathophysiology of achalasia and EED may overlap, leading to the speculation that achalasia may be responsible for the symptoms. Similarly to patients with achalasia without EED, a careful preoperative evaluation is essential in patients with EED. Endoscopy and an esophagram are mandatory in the workup of these patients, while esophageal manometry confirms the associated motility disorder. Treatment is indicated in all patients fit for an operation except those who are asymptomatic with a small EED and no prior history of aspiration. Laparoscopic Heller’s myotomy and partial fundoplication is the most adequate therapy. Diverticulectomy must be added to the procedure in large diverticula. Experience with endoscopic therapy is very limited.

Keywords

Achalasia Esophageal Manometry Partial Fundoplication Endoscopic Balloon Dilatation Laparoscopic Myotomy 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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Copyright information

© Société Internationale de Chirurgie 2015

Authors and Affiliations

  1. 1.Department of Surgery, Escola Paulista de MedicinaFederal University of Sao PauloSao PauloBrazil
  2. 2.Department of Surgery and Center for Esophageal DiseasesUniversity of Chicago Pritzker School of MedicineChicagoUSA

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