case_images: PMC7584271_01
case_images: (a) Upper contrast study showing proximally dilated esophagus and a conical distal narrowing, (b) Initial balloon dilatation reaching to a size of 13.5 mm, (c) Upper contrast study showing epiphrenic diverticulum above diaphragm, (d) Mature chondroid tissue (arrows) in the wall of the resected diverticulum (H&EX100).
case_images: MEDJ-35-261-f1.jpg
case_images: PMC7584271_01_MEDJ-35-261-f1.jpg
case_images: F1
case_images: An upper contrast study (UCS) showed a normal-caliber anastomotic site but a narrowing in the distal esophagus consistent with CES at one year of age (Figure 1a). Endoscopic biopsies were taken and 13.5 mm balloon dilatation was applied (Figure 1b). A UCS confirmed the cystic structure was an ED (Figure 1c). The histopathology revealed the excised diverticulum contained cartilaginous tissue on esophageal side (Figure 1d).
case_images: (a) Endoscopic view of proximal esophageal atresia repair site (arrows) which was widely patent, (b) Distal esophageal stenosis above gastroesophageal junction, (c,d) Endoscopic view of the epiphrenic diverticulum (ED) in relation to the esophagus (E) and the gastroesop-hageal junction (arrow).
case_images: MEDJ-35-261-f2.jpg
case_images: PMC7584271_01_MEDJ-35-261-f2.jpg
case_images: F2
case_images: An endoscopy (EG-450PE5, Fujinon) revealed a widely patent anastomosis at the 14th cm but a circular narrowing at the 20th cm which precluded entry into the stomach (Figure 2a-b). An endoscopic assessment showed presence of a left-sided distal esophageal diverticulum which was non-existent in previous endoscopies performed with the endoscope passing though the GEJ into the stomach readily (Figure 2c-d).
case_images: T2W1 magnetic resonance images (a) Axial view of dilated mid-esophagus (arrow) with an intraluminal feeding tube, (b) Cystic structure (broken arrow) with hyperintense air-fluid level and probable connection with esophageal lumen, (c) Coronal view of proximal portion of the cystic structure (arrow-head) lying on the same plane with the dilated mid-esophagus (arrow) which contains an intraluminal feeding tube (d) Cystic structure (broken arrow) with hyperintense air-fluid level.
case_images: MEDJ-35-261-f3.jpg
case_images: PMC7584271_01_MEDJ-35-261-f3.jpg
case_images: F3
case_images: There was a left preaortic diverticular 17X14 mm cystic structure located 2 cm above gastroe-sophageal junction (Figure 3).