74 LAPAROSCOPIC MANAGEMENT OF A PULSION EPIPHRENIC OESOPHAGEAL DIVERTICULUM SECONDARY TO ACHALASIA. (17th September 2021)

• Record Type: Journal Article
• Authors: Tan, Jeremy; Yeung, Baldwin; Ong, Lester; Toh, Bin Chet; Wong, Wai Keong; Lim, Chin Hong
• Is Part Of: Diseases of the esophagus. Volume 34(2021)Supplement 1
• Publication Date: 2021-09-17
• Subjects: Esophagus -- Diseases -- Periodicals; 616.32
• DOI: 10.1093/dote/doab052.74
• Languages: English
• ISSNs: 1120-8694

Abstract

Abstract: : This is a video submission of a laparoscopic resection of an epiphrenic oesophageal pulsion diverticulum secondary to achalasia. A Heller's cardiomyotomy is also performed together with a Toupet fundoplication. Methods: The patient is a 40 year old woman with a 12 month history of worsening dysphagia, reflux symptoms, as well as occasional regurgitation of food, worse at night. Barium swallow showed a distal oesophageal diverticulum and oesophageal manometry confirmed type 1 achalasia. Upper GI endoscopy showed no other intra-luminal findings. Results: The patient underwent a laparoscopic resection of the diverticulum, together with a Heller's cardiomyotomy and Toupet fundoplication. There were no post-operative complications. She remains well and asymptomatic at 9 month follow-up. Conclusion: Pulsion diverticula secondary to achalasia are a known but rare entity. A few variations exist on how to manage this condition surgically, especially with respect to the type of fundoplication. We present our preferred technique for dealing with this condition. Video: https://www.dropbox.com/s/dg4edkamykugupn/Oesophagealdivert.mp4?dl=0