1. Epiphrenic diverticula
Surbhi Gupta, MS4
Radiology
6/2/17

2. Background DAS, 57 year old female
History of COPD, DMII, coronary artery disease, now presenting with shortness of breath, fever, and cough

3. Initial ddx AND WORKUP Differential diagnosis Workup Pneumonia
Viral illness
Pulmonary embolism
COPD exacerbation
Workup
Vitals: tachycardia, tachypnea
Physical exam: LLE>RLE
Labs: expected changes from ESRD, viral respiratory panel positive
Chest XR
Doppler: negative

4. readmission Patient discharged on day 2
Readmitted 5 days later with SOB and chest discomfort
Workup
Vitals: SpO2 87%
Physical exam: wnl
Labs: expected changes from ESRD
Chest XR: unchanged
Chest CT

8. Epiphrenic diverticula overview
Herniation of submucosa and mucosa through the muscularis propria
Therefore, a false diverticulum
Due to increase intraluminal pressure
Secondary to
Motility disorders: Achalasia, Esophageal spasm
Distal esophageal strictures
Hiatal hernia
Complications
Dysphagia
Distal esophageal compression
Management
If symptomatic, target underlying disorder
Myomectomy or diverticulectomy

9. Final diagnosis Asymptomatic epiphrenic diverticulum Viral URI
No aspiration
No follow up required
Viral URI
Symptomatic management

10. references
disorders/esophageal-and-swallowing-disorders/esophageal-diverticula
interpretation-of-radiographic-studies.html