Diverticulum in the fundus of the stomach, seen at retroflexion. A gastric diverticulum is an unusual anomaly of the alimentary tract. Of the two types, congenital and acquired, the former is far more common. The majority of congenital diverticula protrude from the posterior gastric wall just inferior to the gastroesophageal junction. While most gastric diverticula are asymptomatic, some are associated with epigastric discomfort that can be medically controlled. A distinct minority result in devastating complications such as perforation or hemorrhage. The preoperative diagnosis of a bleeding gastric diverticulum mandates aggressive lavage and thorough endoscopy of the stomach to include a retroflexed view of the cardiac portion of the stomach. Surgical amputation of the bleeding juxtacardiac diverticulum is the treatment of choice.
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