Etiology and Pathology
This condition often results from scarring caused by inflammation of lymph nodes near the tracheal bifurcation or hilum of the lung, which exerts traction on the entire esophageal wall. The diverticulum typically measures 1–2 cm in diameter and may occur as a single lesion or in multiples. The neck of the diverticulum is often relatively wide, making food retention uncommon.
Clinical Manifestations
Symptoms are frequently absent. In cases where inflammation and swelling occur, patients may experience sensations of obstruction during swallowing or pain localized behind the sternum or in the back. Chronic infection can lead to the formation of a connection between the esophageal diverticulum and the lung, resulting in a diverticulo-bronchial fistula. Such cases may present with recurrent localized lung infections and symptoms such as cough and choking.
Diagnosis
Diagnosis is primarily confirmed through esophagography with a barium swallow. Occasionally, gastroscopy is performed to rule out malignancy.
Treatment
Patients who are asymptomatic do not require surgical intervention. For cases involving bleeding, perforation, or significant symptoms, surgical treatment may be considered. Management generally involves freeing the esophageal wall from the external traction and excising the diverticulum.