Intramural pseudodiverticulosis—an unusual cause of benign oesophageal stricture

Abstract

Summary Three cases of intramural pseudodiverticulosis of the oesophagus are described together with a review of the relevant literature. This unusual condition, diagnosed by characteristic features on the barium swallow, is associated with a high incidence of benign oesophageal stricture which responds readily to endoscopic dilatation.

A Case of Esophageal Intramural Pseudodiverticulosis

“…11,12 About 10% of patients require no treatment. 17 If there is concomitant reflux esophagitis or candidiasis, conservative treatment for these diseases sometimes improved both the symptoms and the pseudodiverticulosis. 16 However, when there is an accompanied esophageal stricture, mechanical endoscopic dilatation leads to clinical treatment response.…”

Esophageal Intramural Pseudodiverticulosis

“…This suggested the conditions predispos ing to EIPD development and the condition itself may be more common than previously thought. There appears to be a slight male pre dominance (male:female ratio 1.4:1) [4,5]; the age ranges from 1 to 86 years, 56% of the patients being in their 7th and 8th decades of life. There may be a predominance among …”

“…Most often this is chronic, with some patients reporting symptoms for as many as 25 years before seeking medical attention. Stephens et al [5] summarized 66 cases and found that 80% of the patients complained of dysphagia upon presentation. Of this group, 47% de scribed constant symptoms, 24% intermit tent.…”

“…Esophageal stricture is seen in 70-90% of the EIPD patients [5,9], It remains unclear whether chronic inflammation around the pseudodiverticuli with subsequent submuco sal fibrosis causes the stricture or whether stricture formation is the precipitating factor.…”

Oesophageal intramural pseudodiverticulosis: a cause of dysphagia in a 10-year-old boy

“…The cause of dysphagia in the majority of patients with OIPD is stricture formation [2,9,10,13,14]. It remains speculative whether an in¯ammatory reaction around the diverticula induces stricture formation or whether a primary in¯ammatory process of the oesophagus causes both the stricture and the appearances of OIPD [14].…”