Revision 10 for 'Esophageal pseudodiverticulosis'

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Esophageal pseudodiverticulosis

Esophageal intramural pseudodiverticulosis is an uncommon condition in which there are numerous small outpouchings within the esophageal wall.

Epidemiology

It may occur at any age, but is more common at 50-70 years old. There is a slight male predominance 2.

Associations

Pathology

Intramural pseudodiverticula represent dilated excretory ducts of the deep esophageal mucosal glands 1.

Radiographic features

Fluoroscopy: barium swallow

Barium swallow examination is the study of choice, as the ductal orifices are too small to be seen on endoscopy. Pseudodiverticula are better seen with a single contrast examination than with a double contrast, thin barium examination 1,2

  • numerous, tiny (1-4 mm), flask-shaped outpouchings
  • may be diffusely distributed or clustered.
  • clustering may occur next to peptic strictures
  • viewed in profile, often appear “floating” next to the esophageal wall, as the channel to the lumen is imperceptible
  • viewed en face, may look like ulcers 3
  • intramural tracking may sometimes be seen bridging two or more pseudodiverticula 2 

Treatment and prognosis

Pseudodiverticular rupture with mediastinitis has been reported but is very rare 4.

 

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