Q) What is true about traction diverticula of the esophagus?
a) It is a common diverticulum at the lower end of esophagus
b) Most of these diverticula are symptomatic and require surgery
c) Mediastinal fibrosis is a common etiologial factor
d) They are most common on the left side
c) Mediastinal fibrosis Traction diverticula are formed from pull from granulomatous inflamation from surrounding , most commonly lymph nodes.
Mid esophagus on the right side 4-5 cm either side of carina.
Etiology
Mediastinal infections, tuberculosis, mediastinal fibrosis and histoplasmosis.
True traction diverticula and have all the walls of esophagus.
Clinical Features
Asymptomatic but can present with dysphagia, chest pain and regurgitation.
Complications include bleeding or fistula formation with airway.
Surgical option - right thoracotomy followed by excision of fistula and repair of esophagus in layers with correction of distal obstruction if present.