Year 2017 / Volume 109 / Number 4
Letter to the Editor
Giant esophageal diverticulum as a new clinical indication for endoscopic gastrostomy

314

DOI: 10.17235/reed.2017.4528/2016

Gonçalo Nunes, Carla Adriana Santos, Jorge Fonseca,

Abstract
Persistent mechanical or functional dysphagia is the most common clinical indication for endoscopic gastrostomy (PEG), however less common conditions may justify prolonged enteral feeding to avoid malnutrition and prevent aspiration. The authors report the case of a 76 year old man referred to the artificial feeding outpatient clinic presenting dysphagia, malnutrition and several episodes of aspiration pneumonia. Upper endoscopy showed a giant esophageal diverticulum, ineffective peristalsis and transient lumen narrowing. X-ray and CT scan confirmed a 9cm long diverticulum. Due to a high surgical risk and unsuitability of endoscopic therapy, the patient underwent PEG, which solved aspiration and improved nutritional status. Dysphagia and aspiration due to giant esophageal diverticula emerges as a new clinical indication for PEG in malnourished patients with respiratory aspiration, not previously reported in the literature.
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References
1) Cassivi SD, Deschamps C, Nichols FC et al. Diverticula of the esophagus. Surg Clin North Am. 2005; 85 (3): 495-503.
2) Costantini M, Zaninotto G, Rizzetto C et al. Oesophageal diverticula. Best Pract Res Clin Gastroenterol. 2004; 18(1): 3-17.
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Nunes G, Santos C, Fonseca J. Giant esophageal diverticulum as a new clinical indication for endoscopic gastrostomy. 4528/2016


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Publication history

Received: 08/07/2016

Accepted: 20/07/2016

Online First: 23/02/2017

Published: 31/03/2017

Article Online First time: 230 days

Article editing time: 266 days


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