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Diverticulosis and its complications in the foregut and small bowel
Journal article   Open access

Diverticulosis and its complications in the foregut and small bowel

Simon Roh, Yulia N. Matveeva, John Keech, Kalpaj Parekh and Evgeny V. Arshava
Current Challenges in Thoracic Surgery, Vol.3, p.15
05/2021
DOI: 10.21037/ccts-20-62
url
https://doi.org/10.21037/ccts-20-62View
Published (Version of record) Open Access

Abstract

Diverticulosis of the foregut and small bowel is uncommon. In this article, we provide an overview of various types of esophageal, gastric, and small bowel diverticula. Asymptomatic diverticula are usually found incidentally during imaging or encountered during unrelated procedures and managed conservatively by observation. Symptomatic patients with esophageal diverticula typically present with dysphagia, regurgitation, and aspiration. These symptoms should prompt elective work-up and treatment. Esophageal diverticulum should be a differential diagnosis for dysphagia, and necessary precaution should be taken during endoscopy to prevent inadvertent perforation. Ideally, patients with dysphagia should be evaluated with imaging prior to endoscopy. Spontaneous perforation and bleeding are very rare, and erosive perforation tends to occur secondary to midesophageal traction diverticula. Gastric, duodenal, and small bowel diverticulosis is frequently asymptomatic. Symptomatic cases may present with obstruction, perforation, and bleeding. While endoluminal techniques have be recently utilized for the management of pharyngoesophageal (Zenker’s) diverticulum, other symptomatic and complicated diverticula of the foregut and small bowel required operative treatment. The complications may be life-threatening and require urgent surgical interventions.

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