title: Esophageal diverticula: pathogenesis, clinical aspects, and natural history.
abstract: It has been gradually accepted that esophageal diverticula result from esophageal motor disorders rather than from primary anatomic abnormalities. Twenty-seven patients with these diverticula were evaluated with respect to pathogenesis, clinical aspects, diagnostic tests, therapy, and natural history for a mean of 27 months of followup. Thirteen diverticula were midesophageal, 11 were situated in the distal third of the esophagus, and 3 were in both regions. Esophageal dysmotility was observed in 85% of patients. Specific esophageal motor disorders were more frequent in association with diverticula of the distal third than in midesophageal diverticula, suggesting that they result from a pulsion mechanism. Traction was the possible mechanism in 27% of midesophageal diverticula. Endoscopic esophagitis was seen in one patient and abnormal acid reflux in 25% of the cases, mainly in patients with distal diverticula. Distal diverticula presented with more severe symptoms than did midesophageal diverticula, and 27% of those required surgical treatment. Patients with midesophageal diverticula seem to have a better prognosis than those with more distal disease.
authors.affiliation: Division of Gastroenterology, Clementino Fraga Filho University Hospital, Federal University of Rio de Janeiro Medical School, Rio de Janeiro, Brazil. LEMME@DOMAIN.COM.BR
authors.forename: Fernando Antonio Pinto
authors.initials: FA
authors.lastname: do Nascimento
authors.forename: Eponina M Oliveira
authors.initials: EM
authors.lastname: Lemme
authors.forename: Milton M B
authors.initials: MM
authors.lastname: Costa
mesh_terms: D000328:Adult; D000368:Aged; D001464:Barium; D003679:Deglutition / Q000502:physiology; D004936:Diverticulum, Esophageal / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology*; D004945:Esophagoscopy; D004947:Esophagus / Q000737:chemistry / Q000473:pathology*; D005260:Female; D005471:Fluoroscopy; D005500:Follow-Up Studies; D005764:Gastroesophageal Reflux / Q000150:complications; D006801:Humans; D006863:Hydrogen-Ion Concentration; D008297:Male; D008365:Manometry; D008875:Middle Aged; D009068:Movement; D014057:Tomography, X-Ray Computed; D014743:Videotape Recording
chemical_list: D001464:Barium