title: An uncommon source of upper gastrointestinal bleeding: epiphrenic esophageal diverticulum.
abstract: Esophageal diverticula are rare findings that have an estimated incidence of 1 per 500 000 people per year, even though acute upper gastrointestinal bleeding is a relatively common medical emergency with an incidence of up to 150 per 100 000 people per year and a mortality rate of 7-14%. An 83-year-old man presented with hematemesis and melena. Urgent upper endoscopy revealed an esophageal diverticulum, within which was an adherent clot. Removal of the clot identified a bleeding vessel within the diverticulum; this was successfully clipped and hemostasis was achieved. To the best of our knowledge, this is the first case report of a bleeding epiphrenic esophageal diverticulum that was successfully managed endoscopically with hemostatic clips alone. While rare, our case serves as a reminder that bleeding epiphrenic esophageal diverticula can present as massive upper gastrointestinal bleeding and urgent endoscopic therapy can be life-saving.
authors: Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA tse.chung@mayo.edu.
authors: Chung Sang
authors: CS
authors: Tse
authors: Division of Gastroenterology, Department of Internal Medicine, Yale School of Medicine, New Haven, CT, USA.
authors: Neil D
authors: ND
authors: Parikh
keywords: epiphrenic esophageal diverticulum; esophago-gastroduodenoscopy; upper gastrointestinal bleed