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Background: Gastric diverticula (GD) are the rarest form of gastrointestinal tract diverticulum, with an estimated incidence of 0.013-2.6%. GD are poorly understood and there are no established management guidelines. Only sparse updates have been published since the mid-20th century. This paper reviews the current literature and provides some suggested guidelines for the management of GD., Methods: A search of Medline via OvidSP and Google Scholar for 'gastric diverticulum' and associated synonyms from the year 1950 onwards was performed. We included randomized controlled trials (RCTs), cohort and case-control studies, and case series. Full text, English language manuscripts on adult populations were included., Results: A total of 103 manuscripts were included in the final selection - 77 individual case studies, 23 case series and three reviews. No RCTs, cohort or case-control studies were found. The case studies represent 305 patients, 50.8% female with average age 49.2 years (range 18-80). The most common symptom was abdominal pain (48.2%). The average maximum diameter was 3.97 cm (range 0.5-9). One hundred and four patients were managed operatively. Despite persistent recommendations in the literature that GD > 4 cm should be considered for resection, there are no data supporting this approach., Conclusion: The evidence pertaining to the management of GD is sparse. The decision for operative management should be individualized and based primarily on the presence of symptoms or complications which may be directly attributable to the GD. Where surgery is indicated, a laparoscopic approach, potentially with intra-operative gastroscopy, is appropriate., (© 2023 The Authors. ANZ Journal of Surgery published by John Wiley & Sons Australia, Ltd on behalf of Royal Australasian College of Surgeons.)

Gastric diverticula are quite rare and can be either acquired or congenital. Resection is recommended when the diverticula are large (>4 cm), PPI therapy does not relieve symptoms, and/or complications arise. We present a case of a patient with a long-standing history of symptoms related to a congenital gastric diverticulum that had been found incidentally on imaging during a workup for possible small bowel obstruction. The patient underwent a successful laparoscopic, robotic assisted surgical resection of the congenital gastric diverticulum with complete relief of his symptoms., (Copyright© South Dakota State Medical Association.)

Gastric diverticulum is a rather rare disease. This lesion is diagnosed in about 0.01% of cases during contrast-enhanced X-ray examination and in 0.04-0.11% of patients undergoing endoscopic examination. Symptomatic diverticulum is complicated by diverticulitis, bleeding, perforation and malignant transformation. Therefore, surgical resection is indicated. We report surgical treatment of a patient with diverticulum of the cardiac part of the stomach. Endoscopic and X-ray examination was valuable to establish the correct diagnosis. Laparoscopic approach minimized surgical trauma and reduced surgery time.

Gastric diverticula are rare and usually asymptomatic. This report, however, describes two examples of symptomatic gastric diverticula successfully treated by laparoscopic resection. Both patients were male and in their sixth decade of life. One patient was relatively healthy with no past medical history, whereas the other patient had chronic pain issues and at presentation was also undergoing evaluation for hyperaldosteronism. The patients presented with gastrointestinal symptoms, including nausea, emesis, abdominal pain, and change in bowel function. In both cases, a gastric diverticulum was identified by CT scan, and precise anatomic position was determined by upper endoscopy. After discussion with the treating teams, including a gastroenterologist and surgeon, surgical treatment and resection was elected. Successful laparoscopic removal was accomplished in both patients, and they were discharged home after tolerating liquid diets. Both patients reported resolution of their abdominal symptoms at follow-up.

Gastric diverticula are rare and uncommon conditions. Most gastric diverticula are asymptomatic. When symptoms arise, they are most commonly upper abdominal pain, nausea and emesis, while dyspepsia and vomiting are less common. Occasionally, patients with gastric diverticula can have dramatic presentations related to massive bleeding or perforation. The diagnosis may be difficult, as symptoms can be caused by more common gastrointestinal pathologies and only aggravated by diverticula. The appropriate management of diverticula depends mainly on the symptom pattern and as well as diverticulum size. There is no specific therapeutic strategy for an asymptomatic diverticulum. Although some authors support conservative therapy with antacids, this provides only temporary symptom relief since it is not able to resolve the underlying pathology. Surgical resection is the mainstay of treatment when the diverticulum is large, symptomatic or complicated by bleeding, perforation or malignancy, with over two-thirds of patients remaining symptom-free after surgery, while laparoscopic resection, combined with intraoperative endoscopy, is a safe and feasible approach with excellent outcomes. Here, we present two cases of uncommon large symptomatic gastric diverticula with a discussion of the cornerstones in management and report a minimally invasive solution, with a brief review of the literature.

Gastric diverticula represent a rare pathological condition. They are usually asymptomatic and are often found only by accident during radiologic or endoscopic examination, or during autopsy. Their incidence is low and evenly distributed between men and women. Gastric diverticula are most frequently located on the posterior wall of the cardia and on the lesser curvature of the stomach. The authors present a case study of a 58-year-old patient with severe sideropenic anaemia, a marked weight loss and non-specific dyspeptic symptoms. The suspicion of a diverticulum was raised by a gastroenterologist during gastrofibroscopy and confirmed by a radiologist following a dynamic CT examination of the stomach. The diverticulum had an atypical location beneath the cardia on the greater curvature. The patient was indicated for surgery. During conventional laparotomy, resection of the diverticulum was performed using a linear stapler. The postoperative course was uneventful. Histology confirmed a false diverticulum. The patient is doing well, is asymptomatic, has put on 7 kg since the operation and her blood count is normal.

Background: Gastric diverticulum (GD) is an extremely rare disorder that can easily be overlooked when investigating the cause of abdominal pain. Its diagnosis is founded on a history of gastrointestinal symptoms and a typically unrevealing physical examination, and diagnosis requires confirmation from UGI contrast studies, EGD, and CT scan. Symptomatic GD should be kept in consideration as a cause of abdominal issues, because not only is it treatable, but also complications of GD can be life threatening. The surgical treatment of GDs has evolved from thoraco-abdominal incisions in the early twentieth century to the laparoscopic approach used today., Case Report: The patient is a 45-y-old male presenting with a 4-mo case of dysphagia, small amounts of regurgitation, and abdominal pain but no other symptoms., Results: The patient was diagnosed with a gastric diverticulum, which was subsequently successfully treated with a laparoscopic gastric diverticulectomy., Conclusion: Laparoscopic gastric diverticulectomy is a safe procedure and should be considered as an option to treat symptomatic GD.

Gastric diverticula are rare disorders which present usually with vague upper abdominal symptoms. The diagnosis is based on endoscopic and radiologic findings, but it may remain uncertain until the operation. Herein we report the case of a 46-year-old woman with a diverticulum of the posterior aspect of the upper part of the gastric fundus, referred to our attention for epigastric pain. The preoperative work out evidenced a pouch of the gastric fundus which was misinterpreted as a paraesophageal or a diaphragmatic hernia. The operation was performed by laparoscopy with a 4-port technique and the diverticulum was resected by an endoscopic stapler. The patient is well and symptom-free more than two months after the operation.

Gastric diverticula are rare. In the literature the mentioned incidences vary between 0.01 % and 2.6 % depending on the method of detection. Until now the laparoscopic treatment of gastric diverticula is reported worldwide by eight authors (eight laparoscopic resections and one laparoscopic invagination with oversewing). Between September 2000 and November 2004 we have operated upon two patients laparoscopically for a gastric diverticulum. In two case reports we describe our operative and perioperative procedure. In both cases the gastric diverticulum was resected with a linear stapling device. In the second patient we did simultaneously a laparoscopic 360 degrees -Nissen-fundoplicatio plus dorsal hiatorrhaphy and fundopexy because of reflux disease based on a cardia insufficiency. The dates of the literature concerning incidence, localisation, classifications, symptoms, diagnostic and therapy are summarized and discussed. Our two case reports show, like the cases mentioned in the literature, that symptomatic gastric diverticula can be treated by laparoscopic resection with very good results.

Gastric diverticulum is a rare entity; the patient usually presents with vague abdominal pain, nausea, vomiting, and weight loss. Diverticulectomy is required for patients with intractable symptoms or complications. We report the laparoscopic excision of a gastric diverticulum in a 15-year-old girl who had been symptomatic for 5 years. A five-port technique and a linear cutting and stapling device were used.

Gastric diverticula are rare and occasionally symptomatic. A sensation of fullness in the upper abdomen immediately after meals is the most common symptom. Dyspepsia and vomiting are less common. Ulceration with hemorrhage or perforation has been reported. If it is thought that complaints can be ascribed to the diverticulum and if proton pump inhibitors do not relieve symptoms, surgical resection is an option. Knowledge of the pitfalls in diagnosis and treatment of a gastric diverticulum are essential for successful and complete relief of symptoms. We report a successful laparoscopic approach as a minimally invasive solution to a symptomatic gastric diverticulum.

Gastric diverticula are extremely rare and may be congenital or acquired. Postgastrectomy formation of gastric diverticula has been attributed to outpouching through the weakened wall of the stomach. When symptomatic, gastric diverticula may cause pain, nausea, dysphagia, and vomiting. Gastric diverticula may also be associated with ectopic mucosa, ulcers, and neoplastic changes. We report a case of gastric cardia diverticulum that became symptomatic after laparoscopic Roux-en-Y gastric bypass. The patient was successfully treated with laparoscopic resection.

Gastric diverticula are uncommonly seen in childhood. They typically emanate from the posterior wall of the stomach near the gastroesophageal junction. The authors report on a 15-year-old adolescent boy who presented with a symptomatic gastric diverticulum that was surgically resected. Potential pitfalls in diagnosis and treatment are discussed.

Symptomatic gastric diverticula are rare, mainly occurring in patients between 20 and 60 years of age. In adults, laparoscopic resection seems to be an attractive alternative to conventional surgery, although some authors experienced problems in identifying the diverticulum intraoperatively. We present a case of a gastric diverticulum in a 13-year-old girl and emphasize the difficulties in establishing the diagnosis. Once other gastrointestinal disorders were excluded, a laparoscopy was performed and the diverticulum resected successfully with an endoscopic linear stapler device. This is the first report on laparoscopic resection of a gastric diverticulum in a child. More experience is mandatory to confirm the safety and long-term success of a minimal invasive technique for this pathologic entity in pediatric patients.

A 30-year-old woman presented with halitosis, sour taste, bloating, and right-sided abdominal pain of 3-months' duration. An upper gastrointestinal series revealed a diverticulum in the posterior cardia of the stomach. The patient underwent a laparoscopic resection of the diverticulum. Postoperatively, the patient did well; at a 28-month follow-up, no further symptoms were reported. Laparoscopic removal of a diverticulum produced an excellent outcome.

A rare case of symptomatic gastric diverticulum surgically managed is reported. The pathogenetic and clinical aspects of the disease are discussed and the usefulness of endoscopy as a means for differentiation between medical and surgical cases is stressed. A review of the literature is made and the conclusion is drawn that this uncommon pathology is often asymptomatic and requires surgical management only in complicated cases and in symptomatic patients that are not responding to medical treatment, as showed by the long-term follow-up (333 months) of the reported case.

The authors present the case-history of a rare cause of gastric diverticulum. On account of a very painful symptomatology and X-ray evidence of a diverticulum the authors decided on laparoscopic excision of the diverticulum. The resection was made using a Endo GIA II stapler. The gradual, one-year development of adhesions and a new different algic symptomatology which impeded the subject's occupational activities led the authors to make another laparoscopic operation. After releasing the adhesion between the stomach and the collateral peritoneum the condition improved completely. The patient is now 16 months after re-operation completely free of complaints and performs his physically pretentious work and ingests food without dyspeptic phenomena.

Gastric diverticuli are rare entities that may present with a variety of vague abdominal symptoms. Diagnosis requires endoscopic and radiologic evaluation preceded by clinical suspicion. This is the first report describing the laparascopic excision of a gastric diverticulum. A description of this procedure and suggestions for the workup of gastric diverticuli are presented.

Gastric diverticular are rare and usually are diagnosed incidentally on radiographic examination. Surgical treatment, consisting of simple excision or inversion of the diverticulum, has been reserved for patients with proven symptoms or complications. These procedures have typically required laparotomy, but with the development of advanced endoscopic techniques, a minimally invasive approach may be appropriate. The authors report two cases of gastric diverticula managed laparoscopically and review the literature related to this entity. Between 1993 and 1996, two patients were evaluated for dyspepsia-like gastrointestinal complaints. Both patients were found to have a gastric diverticulum on a contrast study, and one diverticulum was also seen on upper endoscopy. Laparoscopic resection was undertaken in both cases. Flexible gastroscopy was performed intraoperatively to help localize the diverticulum, which was resected with an endoscopic stapling device. Nissen fundoplication was performed in conjunction with the diverticulectomy in the second patient for gastroesophageal reflux. Both procedures were completed laparoscopically without complications. The postoperative course was uneventful in both patients. At long-term follow-up, the patients are asymptomatic. This experience indicates that laparoscopic resection of symptomatic gastric diverticula is a feasible alternative to laparotomy. A prospective analysis to verify the safety and efficacy of this procedure should be done.

Gastric diverticulum is a rare disorder. The laparoscopic approach may be ideal for the resection of gastric diverticulum in some cases. The authors believe this to be the first reported case of gastric diverticulum resected laparoscopically. A 59-year-old woman was admitted with indigestion and epigastric pain. Upper gastrointestinal series showed a single diverticulum (3 x 2 cm) on the posterior wall of the upper part of the stomach. The neck of the diverticulum was relatively narrow. Gastroduodenoscopy revealed that food residues were impacted within the diverticular pouch. Other areas of the stomach and the duodenum were normal. Abdominal ultrasonography showed no other pathologic conditions in the upper part of abdomen. On operation, the lesser sac was entered by division of the greater omentum along the avascular plane of the transverse colonic attachment. The location of the diverticulum was confirmed by intraoperative gastroscopy. Using a 5-cannula techniques, the diverticulum was resected with an endoscopic linear stapler device. Pathologic examination of the resected specimen demonstrated chronic superficial gastritis. Flatus was passed out on the first postoperative day, diet was started from the second day, and the patient was discharged on the fifth day without problems.

A 12-year-old girl presented with long-lasting intractable abdominal pain associated with a gastric diverticulum. The clinicopathologic features of this rare entity are discussed with emphasis on pathogenesis, diagnosis, and treatment. The authors emphasize that congenital diverticulum of the stomach should be considered in the differential diagnosis of abdominal pain in childhood. Surgical treatment consisting of simple excision of the diverticulum is warranted in cases presenting with long-lasting symptoms after failure of medical treatment.

Duplication of the stomach is a rare congenital disease of the childhood. We report the exceptional manifestation in two adults. The clinical presentation and developmental theory is discussed by reviewing the literature. Today the therapy of choice is resection of the duplication with removal of the adjacent wall of the stomach.

The author reports a case of pericardial diverticulum with gastro-oesophageal reflux treated surgically. The diagnosis and the type of treatment that must be adopted are defined. He reviews the literature and compares the described data with the observed case.

Gastric diverticula are very rare and usually asymptomatic diseases. Clinical symptoms may include haemorrhage, mild discomfort and pain in upper abdomen. They are most frequently diagnosed incidentally during X-Ray examinations. In symptomatic diverticulum of gastric fundus was diagnosed roentgenographically and endoscopically and was successfully cured surgically.

The author reports a case of gastric symptomatic diverticulum, not connected to other gastric-biliary-duodenal pathology. The author points out the rarity of diverticulum of the alimentary canal, and points out the symptomatic picture that, in association with a radiologically ascertained diverticulum staunching, represent indications for surgery.

We report a case of adult pyloric obstruction caused by the delayed presentation of a congenital gastric diverticulum. The derivation, classification and treatment of these abnormalities are discussed.

Gastric diverticulum is a rare disease, often benign and specifically located in the right paracardial region. The authors report a case of left paracardial diverticulum with gastro-oesophageal reflux. This association should be treated surgically with resection of the diverticulum, after failure of medical treatment.

An observation is presented, of a female patient aged 62 years with a large abdominal tumour. Clinical and para-clinical examinations could not establish the organic origin of the formation. Surgery disclosed a giant tumour developed in a gastric diverticulum situated under the cardia. The patient had suffered for a long time with gastric symptoms and her antecedents included upper digestive haemorrhage which was attributed to gastric ulcer according to radiological examination. In retrospect it was established that the disturbances were determined by a gastric diverticulum, complicated by haemorrhage and which later on had become malignant. In spite of its extraordinarily large size the tumour was removed by total gastric resection, in an attempt to treat radically the cancer.

Diverticula of the stomach and duodenum were revealed in 21 (2.3%) of the examined patients with ulcer disease. Resection with radical interventions on the diverticulum were fulfilled in 8 patients, with by-passed duodenum in 7 patients, with selective proximal vagotomy associated with invagination of the diverticulum in 6 patients, among them 1 patient with a subpyloric Y-shaped bypass of the duodenum. There were no lethal outcomes.