Pulsion Diverticulum

 Barium-filled outpouchings from esophagus


image Usually smooth, rounded contour and wide neck

image Diverticula tend to remain filled after most of barium is emptied due to lack of muscle in wall
–  

image Single or multiple, of varied sizes

image Almost all patients have evidence of diffuse esophageal spasm or significant dysmotility


• Distal esophageal (epiphrenic) pulsion diverticula
image Large barium-filled sac in epiphrenic area

image Easily mistaken for hiatal hernia




TOP DIFFERENTIAL DIAGNOSES




• Hiatal hernia (especially type 3 paraesophageal hernia)
image Look for gastric folds within hernia

• Traction diverticulum

• Esophageal perforation


CLINICAL ISSUES




• Small diverticula: Usually asymptomatic

• Large diverticula: Dysphagia, regurgitation, halitosis

• Complications
image Perforation, fistula formation, retained foreign body
– Perforation by feeding tube or endoscope is known hazard of pulsion diverticula

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Nov 16, 2016 | Posted by in GASTROINTESTINAL IMAGING | Comments Off on Pulsion Diverticulum

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