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Endoscopic signs of esophageal diverticula
Last reviewed: 23.04.2024
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Diverticulum of the esophagus is a blind organic protrusion of the esophagus wall acquired or congenital (less often) in nature. Diverticula of the esophagus account for 40% of all gastrointestinal diverticula.
True diverticula. The wall of the diverticulum contains all the elements of the esophageal wall. They are more often congenital.
False diverticula. They are essentially hernial protrusions of the mucosa through the weak points of the muscular wall. They can easily stretch, pinch and perforate.
Diverticula can be:
- single - 70-90%,
- multiple - 10-30%.
The mechanism of diverticula formation is:
- Pulsatory. Occur as a result of increased pressure in the esophagus with a disruption in the coordination between pushing food and opening one of the muscle pulp - false diverticula.
- Tractional. Occur as a result of stretching the esophagus wall with paresisophageal scarring - true diverticula.
The shape of the diverticula can be:
- Spherical.
- Oval.
- Pear-shaped.
- Saciform.
The diameter of the message depends on the shape of the diverticulum and its size.
According to topography diverticula are:
- Pharyngeal and esophageal. These include cervical diverticula and Center's diverticulum. Is 3-5%. More often congenital, pulsionnyh character, are located on the back wall of the pharynx and esophagus (prevertebralno). Dimensions from the cherry bones to the baby's head.
- Epibronchial (bifurcation, upper thoracic). They constitute 70-80%, more often traction, caused by tubercular bronchoadenitis. Have a wide entrance. Complications are rare.
- Epiphrenial (supra-diaphragmatic, inferior thoracic), more often pulsatile, are located on the anterior and left lateral walls.
Complications of esophageal diverticula.
- Diverticulitis:
- catarrhal - hyperemia of the mucosa,
- atrophic - thinning of the mucosa,
- erosive-ulcerative,
- fibrinous-purulent,
- scarring and deforming.
- Perforation.
- Bleeding.
- Cancer of the esophagus diverticulum.
In the endoscopic protocol, the level of the diverticulum location, the wall, the size, the depth, the diameter of the inlet, the nature of the mucosa, the contents of the diverticulum, the evacuation of the diverticulum should be indicated.
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