title: Esophageal intramural pseudodiverticulosis: endoscopic diagnosis and therapy.
abstract: Esophageal intramural pseudodiverticulosis is a rare disease that may lead to esophageal stenosis and dysphagia. The aim of the study was to evaluate the endoscopic diagnosis, treatment and clinical course of intramural pseudodiverticulosis. We retrospectively studied endoscopic criteria of intramural pseudodiverticulitis, associated diseases, and the clinical course, particularly in patients with dysphagia because of esophageal stenosis in a period from 2002 to 2012. In 23 patients, the diagnosis was made according to endoscopic criteria. As risk factors, alcohol and tobacco consumption were present in all patients. Concomitant candida infection was present in six (26%) patients. In 12 (52%) patients esophageal stenosis was present, which was localized in the upper half of the esophagus. In 11 patients bougienage has been performed with excellent improvement of the dysphagia score from 3.7 to 1.3 (P = 0.002). However, dysphagia was recurrent in four patients with need for repeated bougienage. About half of the patients with intramural pseudodiverticulosis present with stenosis of the esophagus at the time of diagnosis. In patients with proximal esophageal stenosis and a typical risk constellation, intramural pseudodiverticulosis should be suspected. Treatment of stenosis with bougienage is effective to resolve dysphagia, but repeated bougienage may be necessary.
authors.affiliation: Klinik für Innere Medizin II, Park-Krankenhaus Leipzig, Leipzig, Germany.
authors.forename: U
authors.initials: U
authors.lastname: Halm
authors.forename: R
authors.initials: R
authors.lastname: Lamberts
authors.forename: I
authors.initials: I
authors.lastname: Knigge
authors.forename: J
authors.initials: J
authors.lastname: Mössner
authors.forename: M
authors.initials: M
authors.lastname: Zachäus
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002177:Candidiasis / Q000150:complications; D003680:Deglutition Disorders / Q000209:etiology / Q000628:therapy*; D004106:Dilatation; D004936:Diverticulum, Esophageal / Q000150:complications / Q000175:diagnosis* / Q000628:therapy*; D004940:Esophageal Stenosis / Q000209:etiology / Q000628:therapy*; D004945:Esophagoscopy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies
keywords: dilatation; dysphagia; esophagus; intramural pseudodiverticulosis; stenosis