title: Esophageal intramural pseudodiverticulosis: a rare endoscopic finding.
abstract: A 76-year-old woman, presenting with a 4-year history of progressive dysphagia, was submitted to endoscopic examination. The upper endoscopy revealed a proximal esophageal stricture and inflammatory mucosa associated with multiples small orifices in the esophageal wall, some of them fulfilled with white spots suggestive of fungal infection. This was a typical endoscopic finding of esophageal intramural pseudodiverticulosis, a benign and rare condition, related to chronic esophagitis and others comorbid states, such as gastroesophageal reflux disease or infectious esophagitis, diabetes mellitus, alcohol consumption, and achalasia. Dysphagia is the predominant symptom and can be accompanied by esophageal stricture in 80% to 90% of patients. The pathogenesis is unknown, and as the pseudodiverticulosis is an intramural finding, endoscopy biopsies are inconclusive. The main histological finding is dilation of the submucosal glands excretory ducts, probably obstructed by inflammatory cells. The treatment consists in management of the underlying diseases and symptoms relief. In this particular case, the patient was submitted to antifungal drugs followed by endoscopic dilation with thermoplastic bougies, with satisfactory improvement of dysphagia.
authors.affiliation: Gastrointestinal Endoscopy Unit, São Paulo University Medical School, 05403-900 São Paulo, SP, Brazil.
authors.forename: Luciana Lopes
authors.initials: LL
authors.lastname: de Oliveira
authors.affiliation: Gastrointestinal Endoscopy Unit, São Paulo University Medical School, 05403-900 São Paulo, SP, Brazil.
authors.forename: Fred Olavo Aragão Andrade
authors.initials: FO
authors.lastname: Carneiro
authors.affiliation: Gastrointestinal Endoscopy Unit, São Paulo University Medical School, 05403-900 São Paulo, SP, Brazil.
authors.forename: Elisa Ryoka
authors.initials: ER
authors.lastname: Baba
authors.affiliation: Gastrointestinal Endoscopy Unit, São Paulo University Medical School, 05403-900 São Paulo, SP, Brazil.
authors.forename: Thiago Guimarães
authors.initials: TG
authors.lastname: Vilaça
authors.affiliation: Gastrointestinal Endoscopy Unit, São Paulo University Medical School, 05403-900 São Paulo, SP, Brazil.
authors.forename: Dalton Marques
authors.initials: DM
authors.lastname: Chaves
authors.affiliation: Gastrointestinal Endoscopy Unit, São Paulo University Medical School, 05403-900 São Paulo, SP, Brazil.
authors.forename: Everson Luiz de Almeida
authors.initials: EL
authors.lastname: Artifon
authors.affiliation: Gastrointestinal Endoscopy Unit, São Paulo University Medical School, 05403-900 São Paulo, SP, Brazil.
authors.forename: Eduardo Guimarães Hourneaux
authors.initials: EG
authors.lastname: de Moura
authors.affiliation: Gastrointestinal Endoscopy Unit, São Paulo University Medical School, 05403-900 São Paulo, SP, Brazil.
authors.forename: Paulo
authors.initials: P
authors.lastname: Sakai