Despite my last week’s intentions to stop perseverating on the esophagus, the Dysphagia Fates intervened and I encountered a relatively rare finding this week that was worth sharing. This patient had a prior MBS that showed aspiration, thickened liquids were recommended- a few weeks later, the patient’s medical status had improved overall, but was showing some regurgitation post swallow and cough. The swallow physiology looked relatively normal, I was on the verge of calling the study complete when I decided an esophageal scan was probably a good idea, given the occasional regurgitation being reported. After a couple presentations, a small to medium spot of barium appeared to float out laterally to the esophagus. I suspected an esophageal diverticulum and our Radiologist agreed in his interpretation. We recommended a GI consult to further investigate.
Esophageal diverticulum are typically asymptomatic, but can indicate a condition that may need treatment or at least further assessment. See the link below for a good summary of the types/locations/classifications, as well as info on treatment that is sometimes needed.
Finally, this patient is just another example of how the integration of clinical information as well as findings from an instrumental resulted in the most comprehensive plan of care for the patient.
I won’t even pretend to promise that next week we won’t still be in the esophagus.