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Esophageal intramural pseudodiverticulosis: a rare endoscopic finding
Luciana Lopes de Oliveira1, Fred Olavo Aragão Andrade Carneiro1, Elisa Ryoka Baba1
1Gastrointestinal Endoscopy Unit, São Paulo University Medical School, 05403-900 São Paulo, SP, Brazil.
Case Reports in Medicine
|December 19, 2013
Summary
Esophageal intramural pseudodiverticulosis is a rare condition causing dysphagia. Treatment involves managing underlying causes and symptom relief, as demonstrated by successful endoscopic dilation.
Area of Science:
- Gastroenterology
- Endoscopy
- Pathology
Background:
- Esophageal intramural pseudodiverticulosis (EIP) is a rare condition characterized by multiple small orifices in the esophageal wall.
- It is often associated with chronic esophagitis, gastroesophageal reflux disease, diabetes mellitus, and alcohol consumption.
- Progressive dysphagia and esophageal stricture are predominant symptoms, affecting 80-90% of patients.
Purpose of the Study:
- To present a case of esophageal intramural pseudodiverticulosis.
- To highlight the typical endoscopic findings and diagnostic challenges.
- To discuss the management and treatment outcomes.
Main Methods:
- Upper endoscopy was performed to examine the esophagus.
- Biopsies were taken, though found inconclusive due to the intramural nature of the pseudodiverticula.
- Histological examination revealed dilated submucosal gland excretory ducts.
Main Results:
- Endoscopy revealed a proximal esophageal stricture with inflammatory mucosa and multiple small orifices, suggestive of fungal infection.
- The patient presented with a 4-year history of progressive dysphagia.
- Histological findings indicated dilation of submucosal gland excretory ducts.
Conclusions:
- Esophageal intramural pseudodiverticulosis is a benign condition requiring management of underlying causes.
- Antifungal therapy and endoscopic dilation provided satisfactory symptom relief for dysphagia.
- Early diagnosis and appropriate treatment are crucial for improving patient outcomes.
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