A 31-year-old woman presented to our clinic with a history of intermittent dysphagia to both solid and liquid food for several years. Her dysphagia increased in severity, and in recent months, was accompanied by frequent postprandial chest tightness, and vomiting. Physical examination and routine laboratory workup showed no obvious abnormalities. Oesophagogastroduodenoscopy ,showed an elongated pouch with a blind end originating from the mid-oesophagus. A demarcation was clearly seen between the epithelium in the pouch and the normal oesophageal mucosa. Upper gastrointestinal series .showed an 8·4×2·8 cm pouch stemming from the thoracic oesophagus. The tubular structure’s blind end did not connect with the distal oesophagus, suggesting an incomplete duplication of the oesophagus. CT of chest () also showed a tube-like lesion with internal air-fluid level. Video-assisted thoracic surgery was done to remove the duplication, resulting in improvement of her symptoms.

Oesophageal duplication is a rare congenital malformation and occurs in about one in 8200 livebirths. It can be categorised into cystic or tubular forms, with the cystic type accounting for nearly 90—95% of cases. Oesophageal duplication can cause recurrent dysphagia, hoarseness, vomiting, respiratory distress or even haematemesis. Most duplications are detected before 2 years of age; 25—35% of the duplications were first identified during adulthood. Surgical resections should be considered in symptomatic patients, and close follow-up is recommended for the asymptomatic individuals because malignancy can develop from the pouch.

Source: Lancet