Unusual case of a large midoesophageal diverticulum mimicking unstable angina pectoris

Giant midoesophageal diverticulum--case report and review of the literature

INTRODUCTION

Midoesophageal diverticula >4cm in size are a medical rarity with a dozen reported cases so far. Usually, midoesophageal diverticula tend to be of small size and asymptomatic.

CASE REPORT

We herein present a case of a woman suffering from a midoesophageal diverticulum in a very large dimension--never described in the current literature before--who successfully underwent surgical resection via thoracotomy.

DISCUSSION

If symptomatic, common symptoms are dysphagia and regurgitation. The risk of malignant transformation is low. Treatment of midoesophageal diverticula is based on size and symptoms of the patient. Asymptomatic or small diverticula detected during routine endoscopy can be followed-up without further therapy, whereas symptomatic or large diverticula should be treated surgically by resection. Myotomy should be performed if any motility disorder is evident. Open as well as minimal invasive approach by thoracoscopical surgery is both feasible.

[Gastrointestinal malformations: a cause of chest pain]

Chest pain is an uncommon cause of consultation in childhood and is even less frequent if resulting from digestive causes. We present the cases of two patients with gastrointestinal tract malformations (diverticulum and esophageal duplication cyst) diagnosed after investigation of chest pain. A potential etiology of diverticulum could be a traction effect caused by fibrous adenopathy of tuberculous primary infection. Duplication cysts are inborn defects. Although these malformations are uncommon, clinicians should take them into account in patients with chest pain.