Esophageal intramural pseudodiverticulosis: a reevaluation

Area of Science:

• Gastroenterology
• Radiology
• Pathology

Background:

• Esophageal intramural pseudodiverticulosis is characterized by unusual flask-shaped outpouchings within the esophageal wall.
• It is a rare condition, diagnosed in 0.15% of patients undergoing esophageal radiologic examinations.

Purpose of the Study:

• To report the diagnostic findings and clinical associations of esophageal intramural pseudodiverticulosis.
• To investigate the prevalence and characteristics of this condition in a large patient cohort.

Main Methods:

• Retrospective analysis of 14,350 esophageal radiologic examinations.
• Comparison of single-contrast and double-contrast esophagography techniques for pseudodiverticula detection.
• Review of associated esophageal conditions and patient demographics.

Main Results:

• Esophageal intramural pseudodiverticulosis was diagnosed in 21 patients (0.15%).
• Single-contrast technique detected pseudodiverticula in 28% of patients who underwent both examination types.
• The majority of patients (52%) presented with isolated distal esophageal involvement near peptic strictures.

Conclusions:

• Esophageal intramural pseudodiverticulosis often appears to be a sequela of reflux esophagitis.
• The condition can be associated with other esophageal pathologies, including infections and squamous cell carcinoma.
• Diagnostic imaging techniques, particularly single-contrast barium, may enhance detection of these pseudodiverticula.