Pulsion (epiphrenic) diverticulum

John Barlow

Research output: Chapter in Book/Report/Conference proceedingChapter


Imaging description A lower esophageal pulsion (epiphrenic) diverticulum contains some combination of air, fluid, and debris by CT chest. It may have an obvious connection to the esophagus because of a wide neck. The remainder of the esophagus may be distended since epiphrenic diverticula are caused by partial distal esophageal obstruction. Esophagram can confirm a suspected epiphrenic diverticulum by demonstration of a blind pouch, usually projecting to the right, connected to the distal esophagus by a neck. The diverticulum retains barium (Figure 37.1). Frequently, the esophagram also provides information regarding the functional or mechanical cause of partial distal esophageal obstruction. Importance Pulsion (epiphrenic) diverticula of the thoracic esophagus are less common than pulsion (Zenker) diverticula of the cervical esophagus [1]. Pathologically, a pulsion diverticulum forms when the mucosal and submucosal layers of the bowel are pushed through the muscular layers by increased intraluminal pressure. Pulsion diverticula of the thoracic esophagus typically arise distally secondary to increased intraluminal pressure caused by distal esophageal functional (motility disorder) or mechanical obstruction [2].

Original languageEnglish (US)
Title of host publicationPearls and Pitfalls in Thoracic Imaging
Subtitle of host publicationVariants and Other Difficult Diagnoses
PublisherCambridge University Press
Number of pages2
ISBN (Electronic)9780511977701
ISBN (Print)9780521119078
StatePublished - Jan 1 2011

ASJC Scopus subject areas

  • General Medicine


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