Pulsion Diverticulum
Michael P. Federle, MD, FACR
Key Facts
Terminology
Esophageal saccular protrusion or outpouching; pseudodiverticulum (only mucosal layer)
Imaging
Mid-esophageal pulsion diverticula
Barium-filled outpouchings from esophagus
Usually smooth, rounded contour and wide neck
Diverticula tend to remain filled after most of barium is emptied (due to lack of muscle in wall)
Single or multiple; of varied sizes
Most patients have evidence of diffuse esophageal spasm or significant dysmotility
Distal esophageal (epiphrenic) pulsion diverticula
Large barium-filled sac in epiphrenic area
Top Differential Diagnoses
Traction diverticulum
Hiatal hernia
Esophageal perforation
Clinical Issues
Small diverticula: Usually asymptomatic
Large diverticula: Dysphagia, regurgitation, halitosis
Complications
Perforation, fistula formation, retained foreign body
Perforation by feeding tube or endoscope is known hazard of pulsion diverticula
Treatment: Surgical diverticulectomy (endoscopically)Related posts:
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