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.
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Acknowledgments
This research used equipment funded by Fundação José Bonifácio, Federal University of Rio de Janeiro, Brasil. The authors thank the late Professor Abércio Arantes Pereira and Professor Elise Tonomura who performed and read the CT scans, the staff of the Endoscopy Unit, Division of Gastroenterology, who performed the upper GI endoscopies, and Ms. Rachel Calegário Gomes who did the statistical analysis. Thanks are also go to Dr. Felix R. Zyngier for his comments and review of this article.
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Nascimento, F.A.P.d., Lemme, E.M.O. & M.B.Costa, M. Esophageal Diverticula: Pathogenesis, Clinical Aspects, and Natural History. Dysphagia 21, 198–205 (2006). https://doi.org/10.1007/s00455-006-9028-5
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DOI: https://doi.org/10.1007/s00455-006-9028-5