RESUMEN
BACKGROUND: Esophageal intramural pseudodiverticulosis is an uncommon, idiopathic disorder characterized by multiple small outpouchings protruding from the esophageal lumen. Esophageal intramural pseudodiverticulosis is associated with conditions such as gastroesophageal reflux disease and diabetes mellitus, as well as emergent complications including pneumomediastinum. The most common presenting symptom is dysphagia with associated esophageal stricture formation. While the pathogenesis of EIP has yet to be determined, it is important to bring awareness to this unique disease with distinctive diagnostic findings and treatment options. CASE PRESENTATION: In this case, we present a 62-year-old woman who suffered from dysphagia, an inability to tolerate a regular diet, and unintentional weight loss for several years prior to her diagnoses. She was diagnosed by esophagram and esophagogastroduodenoscopy to have esophageal intramural pseudodiverticulosis, complicated by severe stricture formation. Following treatment with sequential dilatation and maintenance H2-blocker therapy, she achieved significant symptomatic improvement. CONCLUSIONS: This case highlights the importance of accurate identification and treatment of an uncommon cause of dysphagia, esophageal intramural pseudodiverticulosis. Treatment includes dilatational therapy, as successfully demonstrated in our patient. Furthermore, treatment is focused on optimizing medical management, as demonstrated in our patient with the addition of an H2-blocker for GERD, or addressing potentially serious underlying causes, such as carcinoma, with surgery.
Asunto(s)
Trastornos de Deglución/etiología , Diverticulosis Esofágica/diagnóstico por imagen , Trastornos de Deglución/terapia , Dilatación , Diverticulosis Esofágica/complicaciones , Diverticulosis Esofágica/terapia , Endoscopía del Sistema Digestivo , Estenosis Esofágica/complicaciones , Estenosis Esofágica/diagnóstico por imagen , Estenosis Esofágica/terapia , Esofagoscopía , Femenino , Antagonistas de los Receptores H2 de la Histamina/uso terapéutico , Humanos , Persona de Mediana EdadAsunto(s)
Fístula Bronquial/etiología , Diverticulosis Esofágica/complicaciones , Enfermedades del Esófago/patología , Fístula Esofágica/etiología , Anciano , Fístula Bronquial/diagnóstico por imagen , Broncoscopía/métodos , Trastornos de Deglución/diagnóstico , Trastornos de Deglución/etiología , Dilatación/efectos adversos , Diverticulosis Esofágica/patología , Fístula Esofágica/diagnóstico por imagen , Gastrostomía/métodos , Humanos , Yeyunostomía/métodos , Masculino , Stents/efectos adversos , Tomografía Computarizada por Rayos X/métodos , Resultado del TratamientoRESUMEN
Esophageal intramural pseudodiverticulosis is an uncommon esophageal benign disease. The typical finding during endoscopy is the presence of numerous pinhead-sized outpouchings along the esophageal wall. We reported a case of food bolus impaction secondary to esophageal intramural pseudodiverticulosis. A 67-year-old man presented with sudden-onset dysphagia. Multiple tiny orifices were revealed during upper endoscopy. In addition, there were an impacted food bolus and an esophageal web. The patient was treated with balloon dilatation and proton pump inhibitors. As a result the symptoms disappeared completely. Esophageal intramural pseudodiverticulosis is a rare cause of food bolus impaction and its treatment is directed towards the underlying associated conditions as well as the resolution of complications.
La pseudodiverticulosis intramural esofágica es una enfermedad benigna del esófago poco común. El hallazgo típico durante la endoscopia es la presencia de numerosos sáculos del tamaño de una cabeza de alfiler a lo largo de la pared esofágica. Reportamos un caso de impactación de bolo alimentario secundario a pseudodiverticulosis esofágica intramural. Un hombre de 67 años presentó disfagia de aparición repentina. Se encontraron múltiples orificios pequeños en la endoscopia superior. Además, hubo un bolo alimentario impactado y una red esofágica. El paciente fue tratado con dilatación con balón e inhibidores de la bomba de protones. Como resultado, los síntomas desaparecieron por completo. La pseudodiverticulosis intramural esofágica es una causa rara de impactación del bolo alimentario y su tratamiento se dirige a las condiciones asociadas subyacentes, así como a la resolución de complicaciones.
Asunto(s)
Anciano , Humanos , Masculino , Trastornos de Deglución/etiología , Diverticulosis Esofágica/complicaciones , Alimentos , Trastornos de Deglución/terapia , Balón Gástrico , Esofagoscopía , Diverticulosis Esofágica/terapia , Diverticulosis Esofágica/diagnóstico por imagen , Dilatación/instrumentación , Dilatación/métodosAsunto(s)
Diverticulosis Esofágica/complicaciones , Diverticulosis Esofágica/diagnóstico por imagen , Estenosis Esofágica/complicaciones , Estenosis Esofágica/diagnóstico por imagen , Esófago/diagnóstico por imagen , Esófago/patología , Anciano , Bario , Diverticulosis Esofágica/tratamiento farmacológico , Endosonografía , Estenosis Esofágica/tratamiento farmacológico , Esofagoscopía , Humanos , Masculino , Inhibidores de la Bomba de Protones/uso terapéutico , Resultado del TratamientoRESUMEN
Esophageal intramural pseudodiverticulosis is an uncommon esophageal benign disease. The typical finding during endoscopy is the presence of numerous pinhead-sized outpouchings along the esophageal wall. We reported a case of food bolus impaction secondary to esophageal intramural pseudodiverticulosis. A 67-year-old man presented with sudden-onset dysphagia. Multiple tiny orifices were revealed during upper endoscopy. In addition, there were an impacted food bolus and an esophageal web. The patient was treated with balloon dilatation and proton pump inhibitors. As a result the symptoms disappeared completely. Esophageal intramural pseudodiverticulosis is a rare cause of food bolus impaction and its treatment is directed towards the underlying associated conditions as well as the resolution of complications.
Asunto(s)
Trastornos de Deglución/etiología , Diverticulosis Esofágica/complicaciones , Alimentos , Anciano , Trastornos de Deglución/terapia , Dilatación/instrumentación , Dilatación/métodos , Diverticulosis Esofágica/diagnóstico por imagen , Diverticulosis Esofágica/terapia , Esofagoscopía , Balón Gástrico , Humanos , MasculinoRESUMEN
Dysphagia is a common complaint of patients seen at the outpatient clinic as well as at the emergency room. We report esophageal intramural pseudodiverticulosis (EIPD) as a cause of dysphagia that is less known by physicians and it is rarely described in the literature. EIPD is characterized by multiple, segmental or diffuse, flask-like outpouchings in the esophageal wall corresponding to dilated and inflamed excretory ducts of the submucosal esophageal glands. The underlying etiology remains unclear. Esophageal strictures, esophageal candidiasis and gastroesophageal reflux disease are often associated. The diagnosis can be made by upper gastrointestinal endoscopy, but barium esophagography is the modality of choice. Complications of EIPD are rare and include broncho-esophageal and esophagomediastinal fistula, pleural and pericardial effusion, abscesses, gastrointestinal bleeding from a web-like stenosis or esophageal perforation with pneumomediastinum. The treatment for EIPD should be directed towards treating underlying associated conditions and relieving symptoms rather than the pseudodiverticulosis itself.
Asunto(s)
Diverticulosis Esofágica/diagnóstico , Perforación del Esófago/diagnóstico por imagen , Estenosis Esofágica/diagnóstico por imagen , Enfisema Mediastínico/diagnóstico por imagen , Trastornos de Deglución/etiología , Diverticulosis Esofágica/complicaciones , Endoscopía del Sistema Digestivo , Enfermedades del Esófago/complicaciones , Enfermedades del Esófago/diagnóstico , Perforación del Esófago/complicaciones , Estenosis Esofágica/complicaciones , Humanos , Masculino , Enfisema Mediastínico/etiología , Persona de Mediana Edad , Tomografía Computarizada por Rayos XRESUMEN
No disponible
Asunto(s)
Humanos , Femenino , Adulto , Diverticulosis Esofágica/complicaciones , Trastornos de Deglución/diagnóstico por imagen , Trastornos de Deglución/tratamiento farmacológico , Endoscopía del Sistema Digestivo/métodos , Bombas de Protones/uso terapéutico , Diverticulosis Esofágica/epidemiologíaRESUMEN
A 54-year-old woman was referred for assessment of dysphagia and extrinsic compression of the esophagus detected by upper gastrointestinal endoscopy. Computed tomography revealed the rightsided aortic arch with mirror image branching and Kommerell's diverticulum. To relieve the esophageal compression, surgical intervention was indicated. Descending aortic replacement with a Dacron graft was performed through right thoracotomy under partial cardiopulmonary bypass. The patient was discharged without any complication, and her dysphagia disappeared.
Asunto(s)
Aorta Torácica/anomalías , Trastornos de Deglución/cirugía , Diverticulosis Esofágica/cirugía , Esófago , Aorta Torácica/cirugía , Puente Cardiopulmonar/métodos , Constricción Patológica/diagnóstico por imagen , Constricción Patológica/etiología , Constricción Patológica/cirugía , Trastornos de Deglución/etiología , Diverticulosis Esofágica/complicaciones , Diverticulosis Esofágica/diagnóstico por imagen , Esófago/diagnóstico por imagen , Femenino , Humanos , Persona de Mediana Edad , Toracotomía , Tomografía Computarizada por Rayos XAsunto(s)
Trastornos de Deglución/etiología , Diverticulosis Esofágica , Estenosis Esofágica/etiología , Estenosis Esofágica/terapia , Consumo de Bebidas Alcohólicas/efectos adversos , Antiulcerosos/administración & dosificación , Dióxido de Carbono/administración & dosificación , Constricción Patológica , Diverticulosis Esofágica/complicaciones , Esomeprazol/administración & dosificación , Estenosis Esofágica/diagnóstico por imagen , Esofagoscopía , Humanos , Insuflación/métodos , Masculino , Persona de Mediana Edad , Factores de Riesgo , Fumar/efectos adversos , Resultado del TratamientoRESUMEN
We present the rare case of a proximal oesophageal stricture caused by a combination of oesophageal lichen planus without any other manifestations and intramural pseudo-diverticulosis, resulting in significant dysphagia. The diagnosis was not reached until a second set of biopsies were performed after split-dose treatment with proton pump inhibitors. Although local corticosteroid treatment was unsuccessful and symptomatic relief was only achieved after endoscopic dilatation, this case emphasizes the importance of adequate biopsies in the diagnosis of oesophageal strictures.
Asunto(s)
Diverticulosis Esofágica/complicaciones , Estenosis Esofágica/etiología , Liquen Plano/complicaciones , Anciano , Trastornos de Deglución/etiología , Trastornos de Deglución/cirugía , Endoscopía , Estenosis Esofágica/cirugía , Humanos , Liquen Plano/patología , MasculinoRESUMEN
No disponible
Asunto(s)
Humanos , Masculino , Anciano de 80 o más Años , Diverticulosis Esofágica/complicaciones , Diverticulosis Esofágica/fisiopatología , Diverticulosis Esofágica , Enfermedad Pulmonar Obstructiva Crónica/complicaciones , Enfermedad Pulmonar Obstructiva Crónica/diagnóstico , Disnea/complicaciones , Disnea/etiología , Disnea , Capacidad Vital/fisiología , Capacidad Vital/efectos de la radiación , Volumen Espiratorio Forzado/fisiología , Esófago/patología , EsófagoAsunto(s)
Diverticulosis Esofágica/complicaciones , Drenaje , Esofagoscopía , Intubación Gastrointestinal/métodos , Terapia de Presión Negativa para Heridas/métodos , Adulto , Drenaje/instrumentación , Drenaje/métodos , Nutrición Enteral/métodos , Perforación del Esófago/diagnóstico , Perforación del Esófago/etiología , Perforación del Esófago/fisiopatología , Perforación del Esófago/terapia , Esofagoscopía/instrumentación , Esofagoscopía/métodos , Femenino , Humanos , Tomografía Computarizada por Rayos X/métodos , Resultado del TratamientoRESUMEN
We here report a rare case of esophageal intramural pseudodiverticulosis with dysphagia. A 65-year-old man was suffering from intermittent dysphagia for 10 years, which had been worsening in recent months. Endoscopic examination revealed multiple, small, saccular diverticula and mild annular stricture with numerous white plaques from the cervical esophagus to the middle thoracic esophagus. Barium esophagography revealed stricture of the upper thoracic esophagus with multiple tiny flask-shaped outpouchings. Based on this characteristic appearance, we diagnosed esophageal intramural pseudodiverticulosis and inflammation of a narrow segment of the esophagus. Biopsy specimen showed acute and chronic esophagitis with Candida infection. Dysphagia persisted despite resolution of candidiasis, for which we successfully performed endoscopic balloon dilatation of the stricture. After the treatment, the patient has been well and has not been suffering from dysphagia.
Asunto(s)
Dilatación/métodos , Diverticulosis Esofágica/terapia , Endoscopía del Sistema Digestivo/métodos , Anciano , Candidiasis , Enfermedad Crónica , Trastornos de Deglución/etiología , Trastornos de Deglución/terapia , Progresión de la Enfermedad , Diverticulosis Esofágica/complicaciones , Diverticulosis Esofágica/diagnóstico , Estenosis Esofágica/etiología , Estenosis Esofágica/terapia , Esofagitis/complicaciones , Esofagitis/diagnóstico , Esofagitis/microbiología , Esofagitis/patología , Humanos , Masculino , Resultado del TratamientoRESUMEN
No disponible
Asunto(s)
Humanos , Masculino , Adulto , Diverticulosis Esofágica/complicaciones , Diverticulosis Esofágica/diagnóstico , Diverticulosis Esofágica/cirugía , Trastornos de Deglución/complicaciones , Trastornos de Deglución/etiología , Trastornos de Deglución , Gastroscopía/métodos , Gastroscopía/tendencias , Diverticulosis Esofágica/fisiopatología , Diverticulosis Esofágica , Trastornos de Deglución/fisiopatología , Manometría/métodos , ManometríaRESUMEN
UNLABELLED: Esophageal intramural pseudodiverticulosis (EIPD) is a rare disorder in adults, and even more in infants and children. It is characterized by the dilatation of the submucosal esophageal glands. The exact etiology and pathophysiology of EIPD is, however, unknown. Dysphagia is the predominant presenting symptom in both children and adults. CONCLUSION: Here, we present a case of a boy with persistent dysphagia who had a thorough diagnostic workup and was eventually diagnosed with EIPD.