From the Research
Traction diverticula are false diverticula is incorrect, as traction diverticula are true diverticula, whereas pulsion diverticula are false diverticula. Oesophageal diverticula can be classified based on their location as pharyngoesophageal (Zenker's), mid-esophageal, and epiphrenic diverticula. They typically result from either increased intraluminal pressure against a point of weakness in the esophageal wall (pulsion diverticula) or from traction forces pulling the esophageal wall outward (traction diverticula) 1.
- Most oesophageal diverticula are associated with underlying motility disorders such as achalasia, diffuse esophageal spasm, or hypertensive lower esophageal sphincter.
- Patients with oesophageal diverticula may experience symptoms including dysphagia, regurgitation, halitosis, chest pain, and aspiration pneumonia, though some remain asymptomatic.
- Small, asymptomatic diverticula generally require no treatment, while symptomatic cases may necessitate surgical intervention such as diverticulectomy, often combined with myotomy to address any underlying motility disorder.
- Pulsion diverticula are false diverticula, and they are the most commonly encountered type of esophageal diverticula 1.
- Pulsion diverticula are not commonly associated with enlarged lymph nodes, but rather with motility disorders of the esophagus 2.
- Myotomy is not always indicated for pulsion diverticula, but it may be necessary in symptomatic patients to address underlying motility disorders 3.
- The most recent and highest quality study suggests that peroral endoscopic myotomy (POEM) can be a safe and effective treatment for esophageal diverticula, particularly for those associated with achalasia or distal esophageal spasm 4, 5.