Epiphrenic diverticulum is typically demonstrated by computed tomography examination as a thin walled, air or air-fluid filled structure communicating with the esophagus. However, those not associated with a distal esophageal obstruction (stricture, achalasia) may remain contracted in resting state and thus may not be visible. Occasionally the diverticulum may have to be differentiated from mediastinal abscess or tumors and even hiatus hernia.