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.

Article Outline

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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References 

  1. Mendl K , McKay JM , Tanner CH . Intramural diverticulosis of the esophagus and Rokitansky-Aschoff sinuses in the gallbladder . Br J Radiol . 1960;33:496–501
  2. Murakami M , Tsuchiya K , Ichikawa H , et al.   Esophageal intramural pseudodiverticulosis associated with esophageal perforation . J Gastroenterol . 2000;35:702–705
  3. Sabanathan S , Salama FD , Morgan WE . Oesophageal intramural pseudodiverticulosis . Thorax . 1985;40:849–857
  4. Bruhlmann WF , Zollikofer CL , Maranta E , et al.   Intramural pseudodiverticulosis of the esophagus: report of seven cases and literature review . Gastrointest Radiol . 1981;6:199–208
  5. Plavsic BM , Chen MY , Gelfand DW , et al.   Intramural pseudodiverticulosis of the esophagus detected on barium esophagograms: increased prevalence in patients with esophageal carcinoma . Am J Roentgenol . 1995;165:1381–1385
  6. Levine MS , Moolten DN , Herlinger H , et al.   Esophageal intramural pseudodiverticulosis: a reevaluation . Am J Roentgenol . 1986;147:1165–1170
  7. Freud E , Golinsky D , Ziv N , et al.   Esophageal intramural pseudodiverticulosis: a congenital or acquired condition? . J Pediatr Gastroenterol Nutr . 1997;24:602–607
  8. Medeiros LJ , Doos WG , Balogh K . Esophageal intramural pseudodiverticulosis: a report of two cases with analysis of similar, less extensive changes in “normal” autopsy esophagi . Hum Pathol . 1988;19:928–931
  9. Koyama S , Watanabe M , Iijima T . Esophageal intramural pseudodiverticulosis (diffuse type) . J Gastroenterol . 2002;37:644–648
  10. Hahne M , Schilling D , Arnold JC , et al.   Esophageal intramural pseudodiverticulosis: review of symptoms including upper gastrointestinal bleeding . J Clin Gastroenterol . 2001;33:378–382
  11. Canon CL , Levine MS , Cherukuri R , et al.   Intramural tracking: a feature of esophageal intramural pseudodiverticulosis . Am J Roentgenol . 2000;175:371–374
  12. Yochimoto Y , Suzuki K , Yazumi S , et al.   Esophageal intramural pseudodiverticulosis . Gastrointestinal Endosc . 2004;59:691–692
  13. Pearlberg JL , Sandler MA , Madrazo BL . Computed tomographic features of esophageal intramural pseudodiverticulosis . Radiology . 1983;147:189–190
  14. Kahle M , Weber EG . Cysts of the esophagus . Hepatogastroenterology . 1980;27:372–376
  15. Yoneyama F , Kobayashi Y , Miyata K , et al.   Esophageal intramural pseudodiverticulosis treated by balloon dilatation: report of a case . Surg Today . 2004;34:62–64

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

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