Pulsion diverticulae of the mid-esophagus with unknown etiology are usually asymptomatic and therefore considered incidental findings on chest X-rays, barium swallows, or endoscopic procedures. Diagnosis is often delayed due to the rarity of clinical symptoms. The clinical, radiological, etiological and surgical features in a patient with extraordinary symptomatic giant mid-esophageal pulsion diverticulum with history of alkali ingestion are presented here. Alkali injury may yield asymptomatic strictures and/or acquired weaknesses of the esophageal wall, both of which are known to lead to the formation of this giant malady. Putative pathomechanism and suggested therapy including diverticulectomy is proposed in this communication.
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