My Private Experiences With Epiphrenic Esophageal Diverticulum (Plus Suggestions To Assist Cope)

Two New Diagnoses – Epiphrenic Esophageal Diverticulum & Mitral Valve Stenosis

While I haven’t heard a lot excellent news in a very long time, I didn’t anticipate 2025 to be a harbinger of such horrible information. It looks as if I might want to get two main surgical procedures completed, one for a extreme mitral valve stenosis, and the opposite for an epiphrenic esophageal diverticulum. Nicely technically, epiphrenic esophageal diverticula, since there are two of them. Oh, and I additionally broke my molar tooth on Christmas Eve, in order that was a bonus.

*Disclaimer: This text is supposed for academic functions, and is predicated on my private experiences as a affected person. While I’ve completed my utmost to be meticulous in analysis, I’m not a physician, and nothing on this article must be substituted for medical recommendation. Please seek the advice of your personal physician earlier than altering or including any new remedy protocols. This submit may additionally include affiliate hyperlinks. It’s going to value you nothing to click on on them. I’ll get a small referral price from purchases you make, which helps with the upkeep of this weblog. Learn our Privateness Coverage web page for extra info. Thanks!

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Classifications for Esophageal Diverticulum

To be sincere, the analysis for epiphrenic esophageal diverticulum scares me greater than the mitral valve stenosis, solely as a result of it’s so uncommon. In apply, esophageal diverticulum is split into a number of several types of classifications from an anatomical and etiopathogenic standpoint (Constantin et al., 2023). They’re additionally subdivided primarily based on their location. WebMD summarises the several types of esophageal diverticula right here, though the classifications can get much more fine-grained than that (Whitten, 2024, February 20).

Nevertheless, from what I’ve gathered after studying a number of medical journals, there may be presently no agreed upon customary for remedy. Classifications for the illness itself will not be even ‘finalised’, so to talk. That means there is no such thing as a handbook or protocol for docs or surgeons to discuss with for this situation, and it’s primarily ‘play by ear’. Each my surgeon and physician on the hospital have solely seen one case of their profession.

I’ll speak in regards to the stenosis in a separate submit, as I wish to concentrate on my analysis and signs for epiphrenic esophageal diverticulum on this one. This submit is a part of a two-part collection. I’ll share my private experiences on this one; you’ll be able to discover extra analysis and info on esophageal diverticulum on this submit.

How I Discovered About My Epiphrenic Esophageal Diverticulum

I reluctantly admitted myself to the A&E/ER one night, as my forearm was bloated and swollen. It felt like my pores and skin was going to burst. The one purpose I had gone to the A&E was as a result of the GP had assumed it was an abscess.

The rheumatology staff noticed me the subsequent day, while I used to be snoozing alongside the hall of a random ward. They have been collectively sure that it was a blood clot, contemplating I’ve Antiphospholipid Syndrome, a blood clotting dysfunction. Just a few scans and checks later, they have been all stunned that it wasn’t a blood clot, neither was it a fracture.

They did nevertheless, discover some liquid close to my lung, and the outpouching attribute of esophageal diverticulum. In line with Constantin et al. (2023), “someplace between 0.06 – 4% [of epiphrenic esophageal diverticulum] are found by the way, radiologically”.

The swollen arm and liquid within the lung subsequently resolved on their very own. Actually, after they wheeled me in to do a pleural biopsy, they wheeled me again out because the surgeon stated that ‘there was nothing to biopsy’. That is why I hardly ever rush to the A&E for each ache, even when excessive. Residing with power sickness means fixed ache, and the occasional bizarre symptom.

My very own rheumatologist stated that the esophageal diverticula in all probability have been there for a while. He additionally stated it was in all probability unrelated to my different autoimmune illnesses, although I actually beg to vary. I personally assume it doesn’t make sense that none of my lengthy record of medical circumstances are associated.

My Epiphrenic Esophageal Diverticulum Signs

In line with Sato et al. (2023), the foremost signs of esophageal diverticulum are “dysphagia, regurgitation, weight reduction, heartburn, respiratory complaints, and retrosternal ache when swallowing meals”.

My very own largest drawback was and is regurgitation, particularly while asleep in the course of the night time. I wake to violent suits of coughing, as my esophagus tries to purge the meals trapped throughout the pouches. Generally my throat is so irritated that I vomit. Actually, it occurred twice once more final night time.

At first, I had merely assumed that it was GERD/acid reflux disorder, as I’m on long-term steroid remedy for Lupus and Sjögren’s illness. Plus I drink approach an excessive amount of espresso, and my consuming habits will not be the very best (sure, sue me). Once I obtained the analysis for epiphrenic esophageal diverticulum, all the pieces made a lot extra sense.

Different signs I’ve needed to date are: minor incidents of dysphagia (hassle swallowing meals), and being actually gassy. My digestive system makes plenty of bizarre noises, and I really feel bloated and uncomfortable. These are sporadic with no mounted sample. My physician has stated earlier than that I in all probability have Irritable Bowel Syndrome (IBS) too, so I’m undecided what’s triggering what. Persistent sickness comorbidities are enjoyable like that.

As well as, my throat typically feels scratchy, as if there are tiny specks of meals trapped inside it, plastered to the ‘partitions’. There are ‘higher’ and worse days as properly. On the ‘higher’ days, the signs are largely quiescent with some minor coughing. On unhealthy days, that ‘caught’ feeling is there for nearly 24 hours, and I’m unable to eat with out vomiting.

My Improve in Signs

The signs quickly turned worse over time. I’m now being involuntarily woken virtually each night time by violent coughing, regurgitation and vomiting. On a ‘higher’ night time, I wake a couple of times. On a ‘unhealthy’ night time, that will be at the very least each 2 hours.

Mix that with horrendous power urticaria that antihistamines barely alleviate, it signifies that I hardly get a great night time’s sleep. Actually, that occurred once more final night time, as I used to be up till 6am scratching and coughing.

Unsurprisingly, this isn’t nice for my bodily or psychological well being, as I really feel extraordinarily frayed on the edges, and utterly worn out. What kind of life is that this, if I’m in ache and discomfort each day and night time? What makes it much more miserable is that there is no such thing as a treatment to even relieve among the signs both.

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Extra Info About Epiphrenic Esophageal Diverticulum

This part covers extra about epiphrenic esophageal diverticulum particularly. You possibly can learn the analysis submit for extra details about esophageal diverticulum basically.

My two diverticula are primarily epiphrenic in nature (in direction of the tail finish of the esophagus), though one is barely larger up. Out of the assorted varieties of esophageal diverticulum, epiphrenic esophageal diverticulum contains lower than 10% of all instances, with an estimated incidence of 1:500,000 per 12 months (i.e. 1 out of half 1,000,000 folks) (Abdollahimohammad et al., 2014). The commonest is Zenker’s diverticulum, which happens on the high finish of the esophagus.

In line with Alicuben et al. (2023), sufferers with epiphrenic esophageal diverticula are symptomatic solely about 10% to twenty% of the time. Signs have a tendency to start when the diverticulum turns into greater than 5cm (Abdollahimohammad et al., 2014).

Having stated that, each my epiphrenic esophageal diverticula are a little bit smaller than 5cm, and I’ve been progressively symptomatic. I’m not sure if that’s good or unhealthy luck. Good as a result of I assume, properly, treating one thing earlier is normally higher than later. Unhealthy as a result of the signs are clearly not enjoyable.

The Problems of Epiphrenic Esophageal Diverticulum

Many signs of epiphrenic esophageal diverticulum are just like different gastrointestinal and customary medical circumstances, comparable to acid reflux disorder or unwanted side effects of NSAIDs. Because of this, many sufferers with epiphrenic esophageal diverticulum are identified late, which might result in additional issues, comparable to “gastrointestinal bleeding, aspiration pneumonia or most cancers” (Conklin et al., 2009).

The incidence of most cancers in sufferers with epiphrenic esophageal diverticulum is round 0.3% to three%, and it’s typically at a complicated stage when found (Conklin et al., 2009; additionally see: Hjern et al., 2015). In line with Constantin et al. (2023), there may be additionally the danger of growing esophageal most cancers, round 10 years after symptomatic esophageal diverticulum.

Some Different Traits of Epiphrenic Esophageal Diverticulum

In line with Constantin et al. (2023) there may be “no correlation between dimension and retentive character” for epiphrenic esophageal diverticulum particularly. That signifies that meals and liquid can get caught whatever the dimension of the epiphrenic esophageal diverticulum, to present rise to signs.

As well as, “one of many early indicators of meals stasis in a pharyngeal-ED [esophageal diverticulum] is the looks of hydro aerial noises when ingesting fluids”. On account of meals stasis, sialorrhea (hypersalivation) happens (Constantin et al., 2023).

After studying that, I puzzled if my drooling at night time is a consequence of the epiphrenic esophageal diverticula. However as I have to put on a mouthguard for bruxism and TMJ dysfunction points as properly, I suppose it may very well be multifactorial.

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Affirmation of My Epiphrenic Esophageal Diverticulum Prognosis – a Barium Swallow Take a look at

After the incidental discovering of the epiphrenic esophageal diverticulum, I used to be scheduled for a barium swallow check. That is one of many extra definitive checks for esophageal diverticulum, and likewise sure motility problems comparable to achalasia (Sudarshan et al., 2021).

I used to be made to drink a chalky liquid at intervals, because the medical staff watched and timed the move underneath fluoroscopy (a kind of x-ray that reveals the motion of organs in real-time) (MedlinePlus, 2024, August 27). The combination tasted fairly good to me, a bit like yoghurt, however don’t take my phrase for it because the technician stated that nobody else likes it. The docs’ largest concern was achalasia, which the staff determined that I didn’t have primarily based on the check. They have been additionally capable of measure the scale of the diverticula and collect different info from the barium swallow check.

Different Important Preoperative Checks for Epiphrenic Esophageal Diverticulum

I might want to get surgical procedure completed in my surgeon’s opinion. While it’s a reasonably high-risk surgical procedure, I’m going to agree with him, because the signs have gotten insufferable and interferes with my life daily. Some preoperative checks will must be completed, specifically an higher endoscopy and manometry.

While the surgeon has stated that the manometry may not be essential since we’ll have to do a fundoplication (an anti-reflux process) through the Heller’s myotomy (surgical procedure) regardless, I insist upon it. It’s because epiphrenic esophageal diverticulum largely stems from a motility dysfunction, so it’s best to deal with the underlying trigger in that case. While the fundoplication may deal with any present motility dysfunction, I believe it’s greatest to really know what the dysfunction is, if there may be certainly one.

In line with Alicuben et al. (2023), “failure to establish and deal with the underlying motility dysfunction throughout diverticulum resection has been related to excessive charges of recurrence and leak alongside the staple line within the vary of 10% to twenty%.” Additionally they state that, “particularly, failure to carry out an sufficient myotomy in such sufferers has yielded leak charges exceeding 25% when diverticulectomy alone is carried out”.

You possibly can be taught extra about these diagnostic checks, surgical procedures and why they’re essential within the submit right here.

Basic Symptom Administration for Epiphrenic Esophageal Diverticulum

As talked about, there is no such thing as a treatment to assist with symptom aid, and the docs don’t have a lot clue about it both. The recommendation I used to be given by the gastroenterologist was relatively generic, and there aren’t many suggestions on-line both. The closest I’ve discovered for managing epiphrenic esophageal diverticulum are common esophageal gentle meals food regimen suggestions.

An inventory of esophageal gentle meals food regimen suggestions might be discovered on the Cedars Sinai (2018, Might 30) web site, and contains: consuming slowly in small quantities, chewing totally, consuming fluids while consuming to flush the meals down, sitting upright while consuming and as much as 60 minutes after, avoiding meals 3 hours earlier than sleeping, avoiding caffeinated drinks, avoiding powerful meats, abrasive meals and breads with chewy textures, and to cease consuming if you begin to really feel satiated. That is just about what the gastroenterologist has suggested me to do for symptom administration of my epiphrenic esophageal diverticula.

You might or could not have hassle digesting meals in and of itself with epiphrenic esophageal diverticulum. Nevertheless, most of the signs mimic these of esophageal most cancers or a motility dysfunction. Thus, most of the symptom administration suggestions intently resemble these illnesses. It additionally largely is determined by your private signs, how and when it impacts you. As an illustration, regurgitation while sleeping is my largest symptom, so my administration plan may look totally different from yours, when you largely get dysphagia as an alternative.

Dietary modifications and consuming occasions are major ones, nevertheless. In line with Yam et al. (2023, April 24), “if sufferers will not be surgical candidates, then administration with food regimen modifications comparable to consuming bland meals and consuming water after each chunk to assist flush any meals out of the diverticulum is advisable”.

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How I’m Personally Managing My Epiphrenic Esophageal Diverticulum Signs

It’s been plenty of trial and error for me, personally. I’ve a tough concept of which varieties of meals trigger essentially the most injury, having realized the painful approach. By sharing these private experiences, I hope that it saves you some ache.

There are additionally a number of issues I need to strive however have but to do them often, so I’ll replace the submit after I’ve experimented with them a bit extra. One factor I’d prefer to strive is stretching to help with digestion, and make it a nightly routine. It appears protected and easy sufficient to attempt to implement.

Dietary & Life-style Modifications

I hardly ever eat at common timings, so I’m making an attempt to work on that. I believe it’s helped a little bit, primarily as a result of there may be much less acid reflux disorder, which might additionally contribute to irritation alongside the digestive tract – which incorporates the esophagus.

Probably the most painful episode for me to this point was consuming a bag of risotto chips at night time, as a result of I believed that rice crackers can be much less abrasive and simpler to digest than potato or corn chips. I used to be proved so terribly incorrect, as I used to be up all night time coughing and vomiting each 2 hours, and even your entire day after as properly. I now have a phobia of something crunchy, and keep away from them particularly at night time.

Meals Textures Matter a Nice Deal

I’ve discovered that meals which can be both crunchy or flaky to be the worst, and likewise something with plenty of ‘specks’ in it, comparable to black peppercorns.

I in all probability don’t have to clarify ‘crunchy’ to you – stuff like crisps, deep-fried rooster and sure cereals. ‘Flaky’ contains bread, sugary candies like soan papdi (which I like), ginger slices, and mainly something that may be damaged down into strips, if that is sensible.

Bread, particularly sliced bread with plenty of ‘air pockets’ tends to be the worst. It’s because they get chewed up into tiny specks that finally turn into trapped within the pouches of the esophageal diverticula. I can really feel them tickle at my throat, begging to be spat out. And after they refuse to budge, my physique reacts and expels them by way of vomiting.

The suggestion to ‘eat bland meals’ doesn’t attraction to me in in the slightest degree, as a result of I’ve additionally developed a phobia after solely consuming bland meals for months on finish at any time when hospitalised. I name it ‘sick folks meals’, and the thought makes me depressed. Nevertheless, the ache and discomfort from the esophageal diverticula signifies that generally, that’s well worth the sacrifice.

Keep away from Supper at All Prices, if Potential

My sleeping hours are very irregular, as one night time of painsomnia can set off a domino impact for days. So I are likely to eat supper, particularly if I hadn’t had a lot to eat earlier on within the day. While the gastroenterologist did say to not eat 2 hours earlier than sleeping, I discover that I have to keep away from consuming proper after dinner. It was troublesome at first, as a result of my physique had been primed to need to eat at night time. It’s a lot better now although. That little change does make a relatively massive distinction.

I did strive consuming fruit juice at night time as I believed it was categorised as a ‘liquid food regimen’, however that didn’t work out too properly for me in any respect. The fibre from the fruits are usually like ‘strings’, so these get trapped within the esophageal diverticula pouches, too. In line with Marcin (2024, March 25), such fruits are exhausting to digest as a result of fibre “isn’t digested by your physique”. While the esophagus is technically earlier than the digestive juices begin their motion, I assume this rule applies too, however otherwise. I’m studying as I am going alongside.

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Meals Which might be Positive for My Epiphrenic Esophageal Diverticulum

For extra substantial meals, soups and stews (together with stewed meat and greens), work greatest for me to this point. As stews are boiled for a protracted time period, this helps to interrupt the meals product down partially. In a gross metaphorical sense, they’ve been ‘pre-chewed’ a little bit to make issues simpler for you.

I eat much less white rice than the common Asian, because it makes me really feel fairly bloated if I’ve an excessive amount of of it. It’s nonetheless a staple, and aside from bloating, doesn’t trigger an excessive amount of misery. I suppose that’s as a result of they’ve been dehusked and are cooked, making them gentle and fewer fibrous. Noodles and pasta are additionally okay basically, as as soon as once more, I assume it’s as a result of they’ve been cooked at excessive temperatures.

Different meals I can tolerate with the epiphrenic esophageal diverticulum are: mashed potatoes, eggs, fish, spreads (like jams and compotes), any cooked meat or vegetable, and yoghurt. Issues which can be okay on the ‘naughty’ meals record for me embody: ice cream, marshmallow, bingsu (Korean shaved ice dessert), sorbet, jelly and custard.

Meals That Trigger Ache for My Epiphrenic Esophageal Diverticulum

Meals that trigger me essentially the most ache, in hierarchical order, embody: crisps/chips, sliced bread, cookies and biscuits, and high-fibre fruits. While a few of these meals might be fairly plain, keep in mind that it isn’t a lot that your abdomen has hassle digesting them. Moderately, the pouches from the esophageal diverticula lure some meals merchandise extra so than others. The time of consumption issues as properly. So if I need to strive my luck consuming one in every of these meals objects, it’s safer to strive it as early on within the day as doable.

Northwest Minimally Invasive Surgical procedure (2021, April 20) has an info web page for sufferers who’ve had esophageal or abdomen surgical procedure, however the recommendation is fairly related for epiphrenic esophageal diverticulum, too. They state that “it can be crucial that meals consumed be easy in texture to facilitate the motion of meals via the swollen areas of the esophagus or abdomen. Bread merchandise that may broaden with fluid are prevented completely”. Additionally they have a record of meals allowed and meals to keep away from that makes complete sense to me. The record is comparable on the Cedars Sinai (2018, Might 30) weblog about esophageal dietary tips as properly.

Experimenting with Dietary supplements & Medicines for Symptom Aid

I used to be affected by two days of bloatedness and regurgitation some time again, and simply randomly thought I’d strive some magnesium. The justification being that magnesium is a necessary mineral for the right functioning of over 300 enzymes within the physique, which incorporates muscle rest and digestion (Al Alawi et al., 2018).

I took a magnesium carbonate effervescent pill, and was amazed to seek out that it helped to alleviate the epiphrenic esophageal diverticulum signs a good bit. I’m undecided how the esophagus is related, however hey, it helped with some aid from two days of discomfort. Placebo or not, I’ll take it as a win, and one thing so as to add to my ache administration toolkit. (I personally just like the vary of effervescent tablets from Voost.)

Nevertheless, do word that this ‘trick’ isn’t fail-proof. Half the time it doesn’t work and I nonetheless get up coughing and regurgitating. So I assume the magnesium merely aids with digestion and rest basically, which in all probability has an oblique impact on my physique general.

Apparently, I did a search about it the subsequent day, and located that magnesium supposedly helps some individuals who have achalasia. I couldn’t discover any papers for it although, as esophageal diverticulum is a uncommon illness. Healthline has a listing of the several types of magnesium dietary supplements, which is attention-grabbing common information (Hill, 2023, Might 11).

Cough syrup additionally surprisingly appears to assist with the continuous coughing, although it’s irritation from the esophagus, as an alternative of the trachea/windpipe. I suppose it suppresses the urge to cough regardless? Having stated that, each my dad and mom are having a particularly unhealthy chilly and cough in the mean time, so maybe I’ve caught the bug, too. I’ll anticipate a pair extra weeks earlier than concluding on the cough syrup aid.

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Conclusion on My Private Experiences with Epiphrenic Esophageal Diverticulum

In sum, epiphrenic esophageal diverticulum is a particularly uncommon illness with restricted analysis comparatively, so symptom and ache administration are largely via trial and error. While it’s not lethal in and of itself until one thing uncommon occurs (comparable to a rupture that won’t cease bleeding), it tends to worsen over time. There’s additionally a really small danger of esophageal most cancers additional down the highway. It has undoubtedly ruined my high quality of life, particularly with the regurgitation while sleeping at night time. The dietary and way of life modifications are annoying, as a result of managing my different power sicknesses is demanding sufficient.

While I’m actually not wanting ahead to one more high-risk surgical procedure in a comparatively quick span of time, I actually hope that I really feel higher after I recuperate from it. I’ve learn a number of Reddit threads on different sufferers’ experiences with Heller myotomy and fundoplication surgical procedures, and among the aftereffects sound actually painful and scary. However I assume I don’t actually have a lot of a selection, do I?

If you happen to’ve by no means had surgical procedure or been chronically sick – the therapeutic course of is definitely the worst, solely as a result of it’s essentially the most boring, painful and helpless interval. All you are able to do is anticipate the ache to subside and the injuries to shut, which might take months and generally, years. However I assume, hope for symptom aid is what retains me, and others like me, going.

Be taught Extra Concerning the Tremendous Uncommon Illness – Esophageal Diverticulum

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References:

1. Abdollahimohammad, A., Masinaeinezhad, N., & Firouzkouhi, M. (2014). Epiphrenic esophageal diverticula. Journal of Analysis in Medical Sciences : The Official Journal of Isfahan College of Medical Sciences, 19(8), 795–797. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4235103/
2. Al Alawi, A. M., Majoni, S. W., & Falhammar, H. (2018). Magnesium and Human Well being: Views and Analysis Instructions. Worldwide Journal of Endocrinology, 2018, 9041694. https://doi.org/10.1155/2018/9041694
3. Alicuben, E. T., Luketich, J. D., & Levy, R. M. (2023). Epiphrenic Diverticulum. In Pryor, A. D. & Hawn, M. T. (Eds), Operative Methods in Foregut Surgical procedure (2nd ed.), 1. Wolters Kluwer Well being. Retrieved from https://books.google.com.sg/books?id=xmGvEAAAQBAJ
4. Cedars-Sinai. (2018, Might 30). Esophageal Gentle Meals Weight loss program Tips. Cedars-Sinai. https://www.cedars-sinai.org/weblog/esophageal-soft-diet-guidelines.html
5. Conklin, J. H., Singh, D., & Katlic, M. R. (2009). Epiphrenic Esophageal Diverticula: Spectrum of Signs and Penalties. Journal of Osteopathic Drugs, 109(10), 543–545. https://doi.org/10.7556/jaoa.2009.109.10.543
6. Constantin, A., Constantinoiu, S., Achim, F., Socea, B., Costea, D. O., & Predescu, D. (2023). Esophageal diverticula: From analysis to therapeutic administration—narrative assessment. Journal of Thoracic Illness, 15(2), 759–779. https://doi.org/10.21037/jtd-22-861
7. Hill, A. (2023, Might 11). 10 Varieties of Magnesium (and What to Use Every For). Healthline. https://www.healthline.com/vitamin/magnesium-types
8. Hjern, F., Mahmood, M. W., Abraham-Nordling, M., Wolk, A., & Håkansson, N. (2015). Cohort research of corticosteroid use and danger of hospital admission for diverticular illness. British Journal of Surgical procedure, 102(1), 119–124. https://doi.org/10.1002/bjs.9686
9. Marcin, A. (2024, March 25). What Meals Are Simple to Digest? Healthline. https://www.healthline.com/well being/easy-to-digest-foods
10. MedlinePlus. (2024, August 27). Fluoroscopy. MedlinePlus. https://medlineplus.gov/lab-tests/fluoroscopy/
11. Northwest Minimally Invasive Surgical procedure. (2021, April 20). Esophageal Gentle Meals Weight loss program. Northwest Minimally Invasive Surgical procedure. https://www.northwestmis.com/process/esophageal-and-stomach/esophageal-soft-food-diet/
12. Sato, Y., Tanaka, Y., Ohno, S., Endo, M., Okumura, N., Takahashi, T., & Matsuhashi, N. (2023). Optimum surgical approaches for esophageal epiphrenic diverticulum: Literature assessment and our expertise. Medical Journal of Gastroenterology, 16(3), 317–324. https://doi.org/10.1007/s12328-023-01765-2
13. Sudarshan, M., Fort, M. W., Barlow, J. M., Allen, M. S., Ravi, Okay., Nichols, F., Cassivi, S. D., Wigle, D. A., Shen, R. Okay., & Blackmon, S. H. (2021). Administration of Epiphrenic Diverticula and Brief-term Outcomes. Seminars in Thoracic and Cardiovascular Surgical procedure, 33(1), 242–246. https://doi.org/10.1053/j.semtcvs.2020.08.017
14. Whitten, C. (2024, February 20). What to Know About Esophageal Diverticulum. WebMD. https://www.webmd.com/digestive-disorders/esophageal-diverticulum
15. Yam, J., Baldwin, D. L., & Ahmad, S. A. (2023, April 24). Esophageal Diverticula. In StatPearls [Internet]. StatPearls Publishing. http://www.ncbi.nlm.nih.gov/books/NBK532858/