CTICasesMid-Mediastinal Esophageal Diverticulum
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Imaging findings
Chest radiography demonstrates a thin-walled, gas-filled lucency in the middle mediastinum. Contrast-enhanced chest CT confirms a gas- and fluid-filled cystic structure directly communicating with the mid-esophagus, filled with swallowed food and debris, located adjacent to a normal-appearing esophagus.
Key takeaways
Esophageal diverticula in the mid-thoracic region are typically traction diverticula, historically arising from inflammatory or granulomatous disease in adjacent mediastinal lymph nodes (such as tuberculosis or histoplasmosis) that scars and pulls on the esophageal wall. These diverticula can accumulate food debris and fluid, presenting as an incidental gas-filled mediastinal mass or causing chest pain, and must be distinguished from duplication cysts, which generally do not show direct communication with the esophageal lumen.
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