A CASE OF HUGE EPIPHRENIC ESOPHAGEAL DIVERTICULUM WHICH WAS RESECTED TRANSABDOMINALLY VIA ESOPHAGEAL HIATUS

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  • 経腹経食道裂孔経由で切除した横隔膜上部巨大食道憩室症の1例

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Abstract

On x-ray examination esophageal diverticulum with the size of 5×5cm or larger is called huge esophageal diverticulum. This time we experienced a 7.0×7.0cm huge epiphrenic esophageal diverticulum. A 70-year-old woman, who was pointed out an esophageal diverticulum about 30 years before, was admitted to the hospital because of dysphagia and heartburn lasting for recent 18 months. Upper GI series demonstrated an epiphrenic esophageal diverticulum 7.0×7.0cm in size. Endoscopy showed the findings of diverticulitis and food residue in the deverticulum. Her clinical symptoms worsened. Diverticulectomy was performed transabdominally via esophageal hiatus without thoracotomy in order to avoid intra-and postoperative cardiopulmonary complications, because her cardiofunction was very poor. Histological examination revealed marked inflammatory changes in the submucosa and lack of muscularis propria in the diverticular wall, which suggested pulsion diverticulum. The patient had a complete relief of symptoms, and a satisfactory postoperative course.

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