Laparoscopic totally transhiatal diverticulectomy of giant epiphrenic oesophageal diverticulum

Abstract

Epiphrenic diverticulum is a rare form of oesophageal diverticulum involving the distal part of the oesophagus. We report the case of a 51 year-old lady who initially presented with nocturnal coughing and volume reflux. Clinical examination was unremarkable as were initial routine blood investigations. A plain chest radiograph, barium swallow, and computed tomography were performed which demonstrated features of a large oesophageal diverticulum. Oesophagogastroduodenoscopy revealed a wide neck, single diverticulum within the lower third of the oesophagus. Oesophageal manometry undertaken revealed normal oesophageal peristalsis and lower oesophageal sphincter pressure. An elective total transhiatal laparoscopic diverticulectomy with Heller's cardiomyotomy and fundoplication was performed with good symptomatic improvement. The patient made an uneventful recovery and remains symptom free two years postoperatively.