ABSTRACT
Esophageal diverticulum is an outpouching of the esophageal wall. Approximately 65% of diverticulum is asymptomatic. Although bleeding from esophageal diverticulum is a rare symptom, it is a life-threatening complication. The authors report a 45-year-old man with massive upper gastrointestinal bleeding and hypovolemic shock. Esophago-gastro-duodenoscopic examination revealed bleeding from a large epiphrenic esophageal diverticulum. The bleeding point was stopped by endoscopic adrenaline injection therapy. Radiographic examination revealed two esophageal diverticula. The larger one, a wide-mouth diverticulum of the epiphrenic type, was the cause of bleeding. An esophageal diverticulectomy with cardiomyotomy was performed via video-assisted thoracoscopic surgery (VATS). There was no esophageal leakage or post-operative morbidity or mortality. The patient had no recurrent bleeding during 24 months after operation.