alexa Esophageal diverticula: pathogenesis, clinical aspects, and natural history.


Journal of Medical Diagnostic Methods

Author(s): do Nascimento FA, Lemme EM, Costa MM

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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. This article was published in Dysphagia and referenced in Journal of Medical Diagnostic Methods

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