ACHALASIA ASSOCIATED WITH ESOPHAGEAL DIVERTICULA - PREVALENCE AND POTENTIAL IMPLICATIONS

Although esophageal diverticula have been rarely reported in patients with achalasia, their prevalence and the potential implications of the relationship are not well known. We reviewed the medical records and the manometric and radiographic examinations in 120 patients with acha lasia to determine the prevalence of esophageal diverticula and to eva luate their importance in this motility disorder. Esophageal diverticu la were found in only 6 (5%) of 120 patients, and all were located in the lower half of the esophagus. Sex distribution and the prevalence o f dysphagia and regurgitation, which affected all patients with divert icula and 88% of those with achalasia only, were not different signifi cantly. Patients with esophageal diverticula were significantly older (72 vs. 52 years) than those without diverticula. In 5 of 6 patients w ith diverticula, mean lower esophageal sphincter (LES) pressure was 44 .5 mm Hg compared to 39.1 mm Hg in 86 of 114 patients with achalasia o nly. Treatment by pneumatic dilatation was done in 4 patients with eso phageal diverticula and in 105 patients without diverticula. Five esop hageal perforations occurred, all in patients without esophageal diver ticula.