title: Gastric diverticulum and halitosis-A case for surgery?
abstract: BACKGROUND
  Gastric diverticulum is a rare and frequently asymptomatic condition. Symptoms include vague pain, fullness, dyspepsia, vomiting, hemorrhage and perforation. Occasionally, the patient can present with belching and oral fetor.
  
  
  METHODS
  We report a 58-year-old woman with a gastric diverticulum who was suffering from a socially disabling oral fetor. After a thorough evaluation, a laparoscopic resection of the diverticulum was offered and completed successfully. At follow-up, the oral fetor had disappeared. The patient had no complaints and regarded herself as cured.
  
  
  CONCLUSIONS
  Although indications for the treatment of asymptomatic patients remain to be defined, pharmacological therapies including protein pump inhibitors and histamine receptor blockers have been employed, with limited effects in patients with miscellaneous symptoms. Surgery is required when serious complications such as hemorrhage or perforation of the diverticulum occur.
  
  
  CONCLUSIONS
  Surgery is required when serious complications such as hemorrhage or perforation of the diverticulum occur. Therapy resistent social disabling oral fetor may add to the indications for surgery.
authors.affiliation: Department of Gastrointestinal Surgery, Stavanger University Hospital, Stavanger, Norway.
authors.forename: Marius Osaland
authors.initials: MO
authors.lastname: Muis
authors.affiliation: Department of Internal Medicine, Stavanger University Hospital, Stavanger, Norway.
authors.forename: Kristian
authors.initials: K
authors.lastname: Leitao
authors.affiliation: Department of Radiology, Stavanger University Hospital, Stavanger, Norway.
authors.forename: Jorunn
authors.initials: J
authors.lastname: Havnen
authors.affiliation: Department of Gastrointestinal Surgery, Stavanger University Hospital, Stavanger, Norway.
authors.forename: Tom B
authors.initials: TB
authors.lastname: Glomsaker
authors.affiliation: Department of Gastrointestinal Surgery, Stavanger University Hospital, Stavanger, Norway; Department of Clinical Medicine, University of Bergen, Bergen, Norway. Electronic address: jon.soreide@k1.uib.no.
authors.forename: Jon Arne
authors.initials: JA
authors.lastname: Søreide
keywords: Gastric diverticulum; Halitosis; Laparoscopy; Oral fetor; Surgery; Treatment