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September 1959

Epiphrenic Diverticulum of the Esophagus: Surgical Treatment

Author Affiliations

Fellow in the Department of Thoracic Surgery (Dr. Barr).; From the Department of Thoracic Surgery, The Cleveland Clinic Foundation and The Frank E. Bunts Educational Institute.

AMA Arch Surg. 1959;79(3):459-467. doi:10.1001/archsurg.1959.04320090107016

Introduction  Epiphrenic diverticulum is an uncommon entity comprising less than 10% of all esophageal diverticula.1 Occurring in the lower third of the esophagus, usually within the distal 10 cm.,2 it is a false diverticulum, as its wall is primarily mucosa. The epiphrenic diverticulum, like Zenker's pharyngoesophageal diverticulum, is classified as a pulsion type. Mondière3 described this lesion in 1833 and suggested that its etiology was related to increased intraluminal pressure. Since that time little has been added that explains the exact cause of this acquired defect. Some related facts have been observed and have been published in the few reports devoted to this entity. In about 65% of cases, associated cardiospasm occurs.4 Hiatal hernia and diffuse esophageal spasm2 have also been observed in conjunction with epiphrenic diverticulum. Kay5 made a significant observation when he described hypertrophy of the inferior constrictor muscle of the terminal

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