title: Large Epiphrenic Diverticula: A Rare Case Presentation.
abstract: A 70-year old female was admitted to hospital with heartburn and chronic halitosis since 5 years. She was on proton pump inhibitors for the same. Her complaints worsened during the last one-year. Workup comprising of esophago-gastro-duodenoscopy, esophageal manometry, 3D computed tomography scan showed right-sided epiphrenic diverticula measuring 10x10 cm with wide mouth about 5 cm with hypertensive lower esophageal sphincter. Patient underwent a video assisted thoracoscopic surgery for esophageal diverticulectomy using two 45 mm staplers. On day 5, the patient developed leak, which was managed by a covered esophageal stent placement. Patient started on oral feeds from day 3 and the esophageal leak healed completely within 2 weeks. Literature suggests that esophageal leaks treated conservatively took approximately 30-40 days on an average for healing. Literature search did not reveal esophageal leak managed by stent with faster recovery (2 weeks). This is one of the largest epiphrenic diverticuli reported in literature.
authors.affiliation: Department of General Surgery, Grant Medical College & Sir JJ Group of Hospitals , Byculla, Mumbai, India.
authors.forename: Ajay H
authors.initials: AH
authors.lastname: Bhandarwar
authors.affiliation: Department of General Surgery, Grant Medical College & Sir JJ Group of Hospitals , Byculla, Mumbai, India.
authors.forename: Pravin N
authors.initials: PN
authors.lastname: Tungenwar
authors.affiliation: Department of General Surgery, Grant Medical College & Sir JJ Group of Hospitals , Byculla, Mumbai, India.
authors.forename: Yogesh M
authors.initials: YM
authors.lastname: Sawakare
authors.affiliation: Department of General Surgery, Grant Medical College & Sir JJ Group of Hospitals , Byculla, Mumbai, India.
authors.forename: Amol Nanasaheb
authors.initials: AN
authors.lastname: Wagh
authors.affiliation: Department of General Surgery, Grant Medical College & Sir JJ Group of Hospitals , Byculla, Mumbai, India.
authors.forename: Chintan Babubhai
authors.initials: CB
authors.lastname: Patel
authors.affiliation: Department of General Surgery, Grant Medical College & Sir JJ Group of Hospitals , Byculla, Mumbai, India.
authors.forename: Saurabh S
authors.initials: SS
authors.lastname: Gandhi
keywords: Epiphrenic diverticulum; achalasia; leak; stent