Diverticular peroral endoscopic myotomy: management of a complex epiphrenic diverticulum

Epiphrenic diverticula are a rare entity presenting with dysphagia and vomiting in most cases. Conventional treatment usually involves complex thoracic surgeries with considerable morbidity, especially as the condition usually affects elderly patients. The overall mortality rate for surgical management of epiphrenic diverticula is about 5 %, with morbidity rate as high as 20 % [1]. A few case reports and case series have shown successful endoscopic management of epiphrenic diverticula by endoscopic septotomy (DPOEM) [2] [3]. In this video we describe a case of a large complex epiphrenic diverticulum in a 78-year-old man presenting with long-standing dysphagia and vomiting ([Video 1]).