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Article
July 18, 1925

PHARYNGO-ESOPHAGEAL DIVERTICULA: DIAGNOSIS AND PREOPERATIVE MANAGEMENT

Author Affiliations

ROCHESTER, MINN.
From the Section on Medicine, Mayo Clinic.

JAMA. 1925;85(3):178-180. doi:10.1001/jama.1925.02670030020005
Abstract

In 1840, Rokitansky described two types of diverticula of the esophagus, traction and pulsion, and Oekenomides, in 1882, added the traction-pulsion variety.

The traction diverticula are usually situated in the region of the left main bronchus, and caused by extension of inflammation from a mediastinal lymphadenitis. When healing occurs, contraction of scar tissue pulls out a portion of the wall of the esophagus and produces a small sacculation. This type of diverticulum is, as a rule, symptomless, but may give rise to mediastinal abscess with esophagobronchial fistula, or, if obstruction occurs in the esophagus distal to it, a pulsion force is added which may cause the formation of the traction-pulsion type of sacculation.1 This inflammatory traction type is rather frequently seen at necropsy but is rarely recognized during life.

When the pulsion type of diverticulum occurs in the lower portion of the esophagus just above the cardia, it may

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