Journal of the Formosan Medical Association
Volume 109, Issue 3 , Pages 241-244, March 2010

Esophageal Intramural Pseudodiverticulosis Complicated With Stricture

  • Shian-Min Liu

      Affiliations

    • Department of Pathology, Tainan Municipal Hospital, Tainan, Taiwan
    • Corresponding Author InformationCorrespondence to: Dr Shian-Min Liu, Department of Pathology, Tainan Municipal Hospital, 670 Chung-Te Road, Tainan, Taiwan
  • ,
  • Hsing-Hsien Wu

      Affiliations

    • Department of Surgery, Tainan Municipal Hospital, Tainan, Taiwan
  • ,
  • Kuo-Kuan Chang

      Affiliations

    • Department of Internal Medicine, Tainan Municipal Hospital, Tainan, Taiwan
  • ,
  • Li-Jung Tseng

      Affiliations

    • Department of Internal Medicine, Tainan Municipal Hospital, Tainan, Taiwan
  • ,
  • Shu-Chen Han

      Affiliations

    • Department of Radiology, Tainan Municipal Hospital, Tainan, Taiwan
  • ,
  • Lein-Ray Mo

      Affiliations

    • Department of Internal Medicine, Tainan Municipal Hospital, Tainan, Taiwan

Received 13 September 2007; received in revised form 8 April 2008; accepted 12 June 2008.

Abstract 

We report a rare case of diffuse esophageal intramural pseudodiverticulosis in a 35-year-old man complaining of severe dysphagia and vomiting for several months. The advanced morphological change in the esophagus caused irregular track formation, mimicking an ulcerative lesion on esophagogram. Endoscopic examination revealed an esophageal stricture with intact mucosa. Endoscopic ultrasonography and chest computed tomography showed multiple hyperechoic lesions of unknown nature and multiple air collection sites in the esophageal wall, respectively, making diagnosis difficult. The patient finally received a subtotal esophagectomy because of severe symptoms. The lesion was pathologically proven to be intramural pseudodiverticulosis with marked submucosal fibrosis. Our experience suggests that awareness of this rare pathology and the related image changes will be helpful for early diagnosis and treatment in the future.

Key Words:  computed tomography , endoscopic ultrasound , esophagogram , esophagus , pseudodiverticulosis

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PII: S0929-6646(10)60048-4

doi:10.1016/S0929-6646(10)60048-4

Journal of the Formosan Medical Association
Volume 109, Issue 3 , Pages 241-244, March 2010