Gastric diverticulum

Last revised by Rania Adel Anan on 7 Oct 2023

Gastric diverticula are sac-like projections that usually originate from the gastric fundus, most commonly on the posterior surface. They are the least common of the gastrointestinal diverticula. 

Gastric diverticula are rare and commonly detected incidentally. The incidence varies from 0.01% to 0.11% at endoscopy studies 2.

Usually asymptomatic. In some cases they may present as a vague sensation of fullness immediately after meals or as gastric discomfort 2

Complications like ulceration, perforation, torsion, hemorrhage and malignancy are rare and an indication for surgical treatment 3.

They may be congenital (true diverticula that have all layers of the gastric wall) or acquired (false diverticula) and arise virtually anywhere along the stomach 4.

A well defined saccular collection of barium sulfate contrast outpouching from the gastric wall. 

A well defined saccular collection of fluid or gas that demonstrates communication with the gastric cavity (fills with iodinated oral contrast on CT).

Surgical resection is recommended when the diverticulum is large, symptomatic or complicated 3.

In cross-sectional studies gastric diverticula can mimic a left adrenal mass. In fluoroscopic studies, they may mimic a gastric ulcer.

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