A 70-year-old female with an epiphrenic diverticulum (Fig. 1 ) was on diuretics for hypertension. She had remained persistently hypokalemic despite receiving appropriate dosages of potassium supplementation. Examination of diverticular contents following surgical resection revealed that the potassium supplementation pills had become lodged within the diverticular sac (Fig. 2 ).
Barium swallow depicting an epiphrenic diverticulum. Preoperative manometry revealed significant tertiary contractions with intact primary peristalsis. The lower esophageal sphincter relaxed normally which excluded the diagnosis of achalasia.
Resected diverticular sac demonstrating retained potassium supplementation pills. The patient had undergone a successful diverticulectomy, distal esophageal myotomy, and Belsey partial fundoplication through a left thoracotomy. There was minimal mucosal damage or peridiverticular inflammation as these were enteric coated pills. Following surgery, the patient’s hypokalemia resolved.
