Findings that shed new light on the possible pathogenesis of a disease or an adverse effect: Diverticulum of the midthoracic oesophagus and left diaphragmatic relaxation

doi:10.1136/bcr.04.2010.2950

BMJ Case Rep. 2010; 2010: bcr0420102950.

Published online 2010 November 5. doi: 10.1136/bcr.04.2010.2950

PMCID: PMC3027864

Findings that shed new light on the possible pathogenesis of a disease or an adverse effect

Diverticulum of the midthoracic oesophagus and left diaphragmatic relaxation

Nicola Antonacci,¹ Gianluca Sciannamea,¹ Filippo Antonacci,¹ Riccardo Casadei,¹ Claudio Ricci,¹ Salomone Di Saverio,² and Francesco Minni¹

¹Department of General Surgery, S. Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy

²Department of Surgery and Emergency, Emergency and Trauma Surgery Unit, Maggiore Hospital Trauma Center, S. Orsola Malpighi University Hospital , University of Bologna, Bologna, Italy

Correspondence to Nicola Antonacci, Email: nikk79it/at/yahoo.it

Abstract

The case of a 58-year-old man with a large midthoracic oesophageal diverticulum and a left diaphragmatic relaxation who presented with night regurgitations, abdominal bloating, epigastric burning and a sensation of fullness after meals is reported. The patient underwent a successful thoracotomic diverticulectomy with left diaphragmatic plicature. The postoperative course was uneventful. To our knowledge this is the first reported case of an association between midthoracic oesophageal diverticulum and left diaphragmatic relaxation. Moreover, we hypothesised that the diverticulum was caused by a pulsion mechanism due to obstruction of the distal oesophagus secondary to diaphragmatic relaxation.

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