A Rare Case of Esophageal Intramural Pseudodiverticulosis

We report the case of a 45-year-old male who presented with 10-month progressive dysphagia to solids and liquids and was subsequently diagnosed with oesophageal intramural pseudodiverticulosis (EIPD). EIPD is an uncommon benign condition characterized by multiple small outpouchings within the oesophageal wall, measuring about 1-4 mm in length and 1-2 mm in width. This case emphasizes the importance of thorough diagnostic evaluation to exclude associated conditions and potential complications. The patient's symptoms, diagnostic workup, and treatment approaches are discussed, emphasizing the importance of recognizing this rare condition in the differential diagnosis of dysphagia and highlighting the importance of patient follow-up for optimal patient outcomes and to avoid complications. The clinical presentation can vary, but dysphagia is the most common symptom. Treatment of oesophageal intramural pseudodiverticulosis has historically been limited to addressing the underlying condition and symptom management with acid suppression, anti-fungal therapy, and endoscopic dilation in areas of stricture.

Oesophageal intramural pseudodiverticulosis should be considered in any patient with chronic dysphagia, even in younger, healthy individuals without traditional risk factors.Definitive diagnosis requires a comprehensive multimodal workup-endoscopy, barium oesophagography, manometry, pH monitoring, and biopsies-to exclude other aetiologies.Symptomatic relief and disease stability are typically achieved through conservative management with proton pump inhibitors and tailored dietary modifications.Scheduled follow-up with periodic clinic reviews and repeat endoscopy is essential to monitor for stricture formation, rare perforations, or potential malignant transformation.