Esophageal Intramural Pseudodiverticulosis

Abstract

A 66-year-old man presented with severe chronic dysphagia and weight loss. A barium esophagogram revealed a proximal esophageal stricture and multiple pseudodiverticula. After death from aspiration pneumonia, a postmortem examination revealed extensive esophageal pseudodiverticulosis. Clinical presentation, pathogenesis, diagnosis, and management of this unusual disorder are reviewed.

Esophageal intramural pseudodiverticulosis characterized by barium esophagography: a case report

“…Intramural pseudodiverticulosis is most commonly associated with gastrooesophageal reflux and esophagitis and less commonly with alcoholism, diabetes mellitus, Crohn's disease, tuberculosis, Mallory-Weiss syndrome and achalasia [3,4]. The average age at presentation is 54 years and patients typically present with dysphagia, which is frequently associated with stricture formation, as in case we describe here [3,4]. Symptoms usually respond well to anti-inflammatory medication and balloon dilatation of strictures.…”

“…Based on approximately 250 cases reported to date, this condition is slightly more common in men than in women [1,2]. Intramural pseudodiverticulosis is most commonly associated with gastrooesophageal reflux and esophagitis and less commonly with alcoholism, diabetes mellitus, Crohn's disease, tuberculosis, Mallory-Weiss syndrome and achalasia [3,4]. The average age at presentation is 54 years and patients typically present with dysphagia, which is frequently associated with stricture formation, as in case we describe here [3,4].…”

Esophageal Diverticula

“…The pouches are best seen when a double air contrast technique is performed [109]. Pseudodiverticulosis may be diffuse or segmental [105,114,119,120] (Figures 17.11 and 17.12).…”

Esophageal intramural pseudodiverticulosis

“…The exact pathogenesis is not known, but most think that this disorder is likely to occur in a patient who has an esophageal motility disorder accompanied by chronic, mucosal inflammation caused by gastroesophageal reflux or perhaps esophageal infection. These factors result in dilatation in the pre-existing esophageal submucosal glands and ducts, which predisposes to more inflammation and infection, resulting in a downhill spiral [4]. The most common theory is that inflammation is the initiating factor, which results in irritation and dilation of the glands.…”