횡격막상부 식도게실과 동반된 식도 아칼라지아 1예

Abstract

Epiphrenic diverticulum is a relatively rare condition resulting from mucosal herniation through the muscular wall of the esophagus. This pulsion diverticulum is often associated with abnormal esophageal motility such as esophageal achalasia. Although pneumatic dilatation is recommended as the initial treatment for patients with esophageal achalasia, some authors caution against the use of pneumatic dilatation when esophageal achalasia is complicated by epiphrenic diverticulum. A 49-year old female patient was admitted due to progressive dysphagia for both solid and liquid foods, and weight loss and frequent vomiting. She suffered from Heller`s myotomy due to esophageal achalasia 8 years prior. She was diagnosed as having recurrent esophageal achalasia with epiphrenic diverticulum due to incomplete myotomy, using esophagography, esophagogastrodudenoscopy, esophageal manometry, and esopahgeal transit scan. The patient was successfully treated with pneumatic balloon dilatation, and her symptoms markedly improved.