Oesophageal intramural pseudodiverticulosis.

Abstract

Twelve cases of oesophageal intramural pseudodiverticulosis are described and the findings in 85 previously reported cases are reviewed. The condition occurs in all age groups, predominantly in the sixth and seventh decades, with a slight predilection for males. The characteristic radiographic appearance is of multiple flask shaped outpouchings of 1-4 mm with narrow necks communicating with the oesophageal lumen. The source of the pseudodiverticula has been shown to be pathologically dilated excretory ducts of the submucous glands due to chronic submucosal inflammation. The distribution was segmental in 57 cases (59%) and diffuse in 40 (41%). Dysphagia is the main symptom and was found in 85 cases (88%); 88 cases out of 97 had radiological narrowing of the oesophagus; of these, 39 (44%) were in the upper oesophagus, 20 (23%) in the middle oesophagus, and 29 (33%) in the lower oesophagus. Treatment is directed towards management of the associated disorder, as the diverticula themselves rarely cause problems.

A Case of Esophageal Intramural Pseudodiverticulosis

“…4,5 On the contrary, others asserted submucosal fibrosis caused by chronic irritation had resulted in the obstruction of the ductal orifices. 8 EIP shows bimodal peak incidence in teens 9,10 and in the fifties and sixties. 11,12 Patients who have a coexisting disease such as diabetes mellitus, esophageal candidiasis, reflux esophagitis, chronic alcohol abuse, and corrosive acid injury have a higher risk to develop EIP.…”

“…11,12 Patients who have a coexisting disease such as diabetes mellitus, esophageal candidiasis, reflux esophagitis, chronic alcohol abuse, and corrosive acid injury have a higher risk to develop EIP. 8,13 EIP is often associated with benign esophageal disease, but there are several reports where EIP was associated with esophageal cancer. 3,14 In one report, a 60-yearold male patient had esophageal cancer in the cervical esophagus and EIP throughout the whole esophagus.…”

“…EIP appears as multiple small flask-shaped outpouchings measuring about 1-4 mm in length and 1-2 mm in width. 8,11 The number of pseudodiverticula varies from less than five to over 20. EIPs are distributed diffusely in 60% of patients and segmentally in 40% (upper 14%, middle 14%, and lower 12%) of patients.…”

Operative Management of Pulmonary Abscess Due to Spontaneous Perforation of Diffuse Intramural Esophageal Pseudodiverticulosis

“…Th e condition occurs in all age groups, predominantly in the sixth and seventh decades, aff ecting slightly more men than women (2). Th e distribution of disease is segmental in about 60% and diff use in about 40% (2).…”

“…Th e distribution of disease is segmental in about 60% and diff use in about 40% (2). Th e most common presentation is progressive or intermittent dysphagia, often secondary to a benign stricture (3).…”