Large Epiphrenic Esophageal Diverticulum: An Unexpected Trap at the Distal Esophagus

Esophageal diverticula are rare and typically asymptomatic, but when symptomatic, they can present with life-threatening complications. They are categorized based on location and esophageal layer involvement. Their underlying pathophysiology involves either a traction or a pulsion mechanism. Epiphrenic diverticula lack a muscular layer and are typically caused by pulsion secondary to an underlying motility disorder. The underlying anatomy and pathophysiology help determine the most appropriate management approach. Treatment includes a range of endoscopic and surgical techniques and must be individualized on a case-by-case basis.