Peroral Endoscopic Myotomy for Epiphrenic Diverticulum in a High-Risk Patient With Esophagogastric Junction Outlet Obstruction
Division
North Florida
Hospital
North Florida Regional Medical Center
Document Type
Case Report
Publication Date
4-8-2026
Keywords
diverticulotomy, double-tunnel POEM, epiphrenic diverticulum, esophagogastric junction outflow obstruction, per oral endoscopic myotomy
Disciplines
Digestive System Diseases | Internal Medicine | Medicine and Health Sciences
Abstract
Epiphrenic diverticula are rare and often debilitating, particularly when associated with esophagogastric junction outflow obstruction, and their management is challenging in high-risk surgical candidates. We describe a 77-year-old woman with severe dysphagia, regurgitation, and significant weight loss caused by a large distal epiphrenic diverticulum and esophagogastric junction outflow obstruction. Given her multiple comorbidities, she was not a surgical candidate and underwent peroral endoscopic myotomy with diverticulotomy. The procedure was completed safely, resulting in complete symptom resolution and normalization of her Eckardt score. This case highlights peroral endoscopic myotomy with diverticulotomy as a minimally invasive, anatomy-directed solution for complex esophageal diverticula.
Publisher or Conference
ACG Case Reports Journal
Recommended Citation
Kalsi H, Essilfie Quaye K, Creamer C, Abuassi M, Brar TS, Perbtani Y. Peroral Endoscopic Myotomy for Epiphrenic Diverticulum in a High-Risk Patient With Esophagogastric Junction Outlet Obstruction. ACG Case Rep J. 2026;13(4):e02064. doi:10.14309/crj.0000000000002064