Beyond Neoplasia and Motility Disorders: An Uncommon Case of Dysphagia Owing to a Benign Stricture

Abstract

Question: A 59-year-old man with a past medical history of diabetes was referred to us owing to heartburn, regurgitation, and intermittent episodes of dysphagia for solids. The patient had been empirically treated for candidiasis. An upper endoscopy revealed multiple pseudodiverticula throughout the esophagus, with esophageal luminal narrowing transposable to the gastroscope with resistance (Figure A, B). Biopsy specimens showed chronic unspecific inflammation with no signs of eosinophilic or lymphocytic esophagitis. Barium esophagogram confirmed numerous outpouchings mainly in the middle esophagus (Figure C). Clinical improvement was seen after beginning proton pump inhibitors. What is the diagnosis? Look on page 846 for the answer and see the Gastroenterology web site (www.gastrojournal.org) for more information on submitting your favorite image to Clinical Challenges and Images in GI.