Article

Les diverticules de l’œsophage

Service de Chirurgie Digestive, Hôtel-Dieu, Boulevard Léon Malfreyt, F-63058 Clermont-Ferrand, France
Acta Endoscopica (Impact Factor: 0.16). 08/2006; 36(4):605-615. DOI: 10.1007/BF03003763

ABSTRACT Les diverticules de l’œsophage sont rares, souvent asymptomatiques et découverts de façon fortuite. Ils sont l’expression
d’un trouble de la motricité œsophagienne sous jacent responsable d’une augmentation de la pression intra-œsophagienne. Les
diverticules asymptomatiques ne doivent pas être traités, à l’inverse des diverticules symptomatiques, compliqués ou volumineux.
La chirurgie est le traitement de choix, par myotomie longitudinale œsophagienne éventuellement associée à une diverticulectomie
ou une diverticulopexie. Pour les diverticules pharyngo-œsophagiens (de Zenker), la diverticulostomie endoscopique par pince
mécanique ou électrocoagulation est devenue une alternative à la chirurgie, notamment chez les patients âgés.
Diverticula of the oesophagus are rare and often asymptomatic or discovered incidentally. They are symptomatic of an ongoing
oesophageal dysmotility process, resulting in abnormal intraluminal pressure. Asymptomatic diverticula can remain untreated,
unlike of symptomatic, complicated or giant diverticula. Surgery is the treatment of choice and consists in longitudinal oesophageal
myotomy eventually associated with diverticulectomy or diverticulopexy. In pharyngoesophageal (Zenker’s) diverticulum, endoscopic
diverticulostomy with stapler, laser or coagulation, has become an alternative to surgery, particularly in elderly patients.

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