Symptomatic esophageal diverticula are rare in infants and children [1]. We report a 6-year-old boy with esophageal diverticulum who presented to us with dysphagia, frequent vomiting, and chest pain since one year of age, mimicking a simple gastroesophageal reflux.

On physical examination, his growth was normal. A barium esophagram showed a sac-shaped esophageal diverticulum arising from the left side of the lower third of the esophagus (Fig 1). Esophagoscopy demonstrated a broad-based esophageal diverticulum with grossly normal mucosa. Surgery was recommended but his family refused. He did not receive any medication. However, he changed his eating habits and chewed solid food well before he swallowed it. One-year later, he still vomited sometimes but had no dysphagia or chest pain.

Fig. 1 The barium esophagram showed one diverticulum (arrow) arising from the left side of the lower third of the esophagus.

Esophageal diverticula are unusual small lesions that are asymptomatic at first. As with our patient, retention of a food within a diverticulum probably contributes to the progressive enlargement of the pouch and may cause regurgitation or vomiting, dysphagia or chest pain [1]. The mild and uncomplicated reflux-like symptom usually delays the prompt diagnosis in children with esophageal diverticulum. Treatment is generally reserved for symptomatic patients and surgery is the mainstay, when nutritional or respiratory complications are present [2,3].