A case of giant esophageal epiphrenic diverticulum resected laparoscopically, followed by Heller myotomy and Dor fundoplication

Atsuta, Koji; Ozawa, Soji; Yoshida, Rie; Arakawa, Satoshi; Kawase, Jin; Oshima, Hisanori; Nagata, Hidetoshi; Shiraishi, Tenzou; Kawabe, Norihiko; Umemoto, Shunji

doi:10.1007/s10388-008-0156-x

Cited by 2 publications

(1 citation statement)

References 19 publications

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“…With advances in minimally invasive operative techniques [ 23 – 25 ], laparoscopy has also become a reasonable alternative to open surgery, and laparoscopic diverticulectomy with myotomy and fundoplication are now considered to be the approach of choice in most cases [ 5 , 9 , 26 ]. Although there have been some case reports of epiphrenic esophageal diverticula that were resected laparoscopically [ 27 , 28 ], almost the entire diverticulum could be visualized laparoscopically from the esophageal hiatus by pulling the esophagus caudally. In the present case, although the left-sided diverticulum could be identified by a transhiatal approach, the huge diverticulum present in the upper part of the esophagus could not be observed.…”

Section: Case Presentationmentioning

confidence: 99%

Multiple huge epiphrenic esophageal diverticula with motility disease treated with video-assisted thoracoscopic and hand-assisted laparoscopic esophagectomy: a case report

et al. 2017

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BackgroundEpiphrenic esophageal diverticulum is a rare condition that is often associated with a concomitant esophageal motor disorder. Some patients have the chief complaints of swallowing difficulty and gastroesophageal reflux; traditionally, such diverticula have been resected via right thoracotomy. Here, we describe a case with huge multiple epiphrenic diverticula with motility disorder, which were successfully resected using a video-assisted thoracic and laparoscopic procedure.Case presentationA 63-year-old man was admitted due to dysphagia, heartburn, and vomiting. An esophagogram demonstrated an S-shaped lower esophagus with multiple epiphrenic diverticula (75 × 55 mm and 30 × 30 mm) and obstruction by the lower esophageal sphincter (LES). Esophageal manometry showed normal peristaltic contractions in the esophageal body, whereas the LES pressure was high (98.6 mmHg). The pressure vector volume of LES was 23,972 mmHg2 cm. Based on these findings, we diagnosed huge multiple epiphrenic diverticula with a hypertensive lower esophageal sphincter and judged that resection might be required. We performed lower esophagectomy with gastric conduit reconstruction using a video-assisted thoracic and hand-assisted laparoscopic procedure. The postoperative course was uneventful, and the esophagogram demonstrated good passage, with no leakage, stenosis, or diverticula.ConclusionsThe most common causes of mid-esophageal and epiphrenic diverticula are motility disorders of the esophageal body; appropriate treatment should be considered based on the morphological and motility findings.

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Section: Case Presentationmentioning

confidence: 99%

Multiple huge epiphrenic esophageal diverticula with motility disease treated with video-assisted thoracoscopic and hand-assisted laparoscopic esophagectomy: a case report

et al. 2017

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A Case of Epiphrenic Esophageal Diverticulum that Required an Operation at Follow-up 4 Years 9 Months Later

太志¹,

久雄²,

信忠³

et al. 2009

Nichidai Igaku Zasshi

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We report a case of epiphrenic esophageal diverticulum that was resected 4 years 9 months after it was first observed. A 47-year-old man exhibited an epiphrenic esophageal diverticulum of 2.5 cm in size during a health screening examination. He was followed but was asymptomatic. About 4 years later, the diverticulum size was enlarged to 5 cm during the health screening examination. Six months later, he presented with symptoms, including heart burn and esophageal reflux. Resection of the diverticulum was performed with Heller myotomy, Dor fundoplication and Hill fixation. The postoperative course was good. In case of esophageal diverticulum, which is symptomatic or becomes enlarged during follow-up, surgery should be performed. As part of the surgical procedure, it is important to prevent post-operative esophageal reflux.

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A case of giant esophageal epiphrenic diverticulum resected laparoscopically, followed by Heller myotomy and Dor fundoplication

Cited by 2 publications

References 19 publications

Multiple huge epiphrenic esophageal diverticula with motility disease treated with video-assisted thoracoscopic and hand-assisted laparoscopic esophagectomy: a case report

Multiple huge epiphrenic esophageal diverticula with motility disease treated with video-assisted thoracoscopic and hand-assisted laparoscopic esophagectomy: a case report

A Case of Epiphrenic Esophageal Diverticulum that Required an Operation at Follow-up 4 Years 9 Months Later

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