Esophageal intramural pseudodiverticulosis

Recurrent Dysphagia Associated with Esophageal Intramural Pseudodiverticulosis

Esophageal intramural pseudodiverticulosis (EIPD) is a rare disorder of the esophagus characterized by the presence of outpouching flask-shaped lesions. These lesions represent false lumens that may be scattered throughout the esophageal wall. We present a rare case of EIPD complicated with esophageal strictures. The case is unique because the small lesions of EIPD remained undiagnosed for many years on prior esophagogastroduodenoscopy examinations until complicated with worsening symptoms of dysphagia due to esophageal stricture. The patient was managed with serial dilations of esophageal stricture. Diagnosing these lesions may be missed in early stages as the lesions are small and may require other radiological modalities to confirm the diagnosis. EIPD lesions itself can be managed conservatively with anti-inflammatory therapy and treatment of underlying risk factors. Those with severe disease and coexisting complications are managed with endoscopic or surgical interventions.

Not always eosinophilic esophagitis – intramural pseudodiverticulosis of the esophagus – a case report and literature review

Background Intramural pseudodiverticulosis of the esophagus (EIPD) is a rare disease leading to dysphagia, chest pain, and weight loss. The diagnosis is difficult, and the disease can be confounded with eosinophilic esophagitis (EoE). We present a patient with esophageal intramural pseudodiverticulosis and a literature review.

Case report The 45-year-old white caucasian woman with a history of nicotine and alcohol abuse had progressive hoarseness and severe dysphagia for solid food. Esophagogastroduodenoscopy (EGD) showed proximal esophageal stenosis, thrush esophagitis, and mucosal alteration with trachealization suspicious of EoE. However, repeated bouginage EGD and barium swallow revealed typical signs of esophageal intramural pseudodiverticulosis (EIPD). The patient was treated successfully by bougingage, acid suppression, and antifungal therapy. The literature analysis revealed the characteristics of EIPD according to age, sex, risk factors, and therapy modalities.

Conclusion The case report and the literature overview suggest that EIPD can be confounded with EoE.

Esophageal intramural pseudodiverticulosis characterized by barium esophagography: a case report

Introduction

Esophageal intramural pseudodiverticulosis is a rare condition characterized by the dilatation of the submucosal glands.

Case presentation

We present a case of esophageal intramural pseudodiverticulosis in a 72-year-old Caucasian man who presented with dysphagia and with a background history of alcohol abuse. An upper gastrointestinal endoscopy of our patient showed an esophageal stricture with abnormal mucosal appearances, but no malignant cells were seen at biopsy. Appearances on a barium esophagram were pathognomonic for esophageal intramural pseudodiverticulosis.

Conclusion

We demonstrate the enduring usefulness of barium esophagography in the characterization of abnormal mucosal appearances at endoscopy.

Esophageal intramural pseudodiverticulosis with esophageal strictures successfully treated with dilation therapy

We report a rare case of esophageal intramural pseudodiverticulosis with esophageal strictures. Barium esophagogram demonstrated multiple flask-shaped diverticula out of the esophageal wall with comprehensive luminal stenosis involving the proximal 8 cm and distal 4 cm of the esophagus. Chest computed tomographic scan demonstrated round wall thickening and several intramural gas collections of the proximal esophagus. Endoscopy revealed a fibrotic stricture and multiple small orifices of pseudodiverticula with mild inflammatory changes. Biopsy specimens showed active chronic inflammatory changes of the mucosa with candidiasis. Dysphagia improved dramatically with esophageal dilation. However, the tiny diverticula did not resolve after treatment.

Esophageal Intramural Pseudodiverticulosis

Esophageal intramural pseudodiverticulosis (EIPD) is an uncommon esophageal abnormality that is best diagnosed with a barium esophagram. The disorder is usually associated with other esophageal pathology, including strictures, motility disturbances, and other conditions that are outlined later. There is no specific treatment (either surgical or medical) for EIPD itself, and treatment should be directed at the underlying, associated conditions. If this condition is diagnosed on a barium study, endoscopy usually is needed to treat an associated stricture or to diagnose an associated inflammatory condition (particularly acid reflux and esophageal infections). Thus, endoscopy and barium studies are critical to guide the management of this condition.

[Intramural pseudodiverticulosis of the esophagus. A case report and review of the literature]

Oesophageal intramural pseudodiverticulosis is a very rare cause of dysphasia. This work reports the observation of a 42 year-man who presented with dysphasia; Diagnosis was established by baryum meal. The patient underwent an oesophagectomy because of failure of endoscopic dilatation. Pathologic examination revealed characteristic lesions of esophageal pseudodiverticulosis, with fissures between the lumen and sero-mucosal glands located in the oesophageal wall and containing Candida spores. By means of a review of the relevant literature, etiopathogenesis, diagnosis and treatment of oesophageal intramural pseudodiverticulosis are discussed.