Etiology and Pathology
This condition arises near the lower segment of the esophagus, close to the diaphragm, often at a weak point in the muscular layer. Factors such as achalasia or hiatal hernia can lead to increased intraluminal pressure, causing the esophageal mucosa to herniate outward. It most commonly occurs on the posterior right side of the lower esophagus. In a minority of cases, the diverticulum involves the entire esophageal wall, forming a true diverticulum.
Clinical Manifestations and Diagnosis
The primary symptom is pain located behind the sternum or in the upper abdominal region. Dysphagia or food regurgitation may occasionally occur. Diagnosis relies mainly on esophagography with a barium swallow, which can reveal the diverticular sac, neck, and its position and orientation.
Treatment
Patients with significant symptoms or food retention may require surgical excision of the diverticulum. Concurrent treatment of other related esophageal or diaphragmatic conditions is usually performed.