title: Esophageal intramural pseudodiverticulosis, a rare cause of food impaction: case report and review of the literature.
abstract: Esophageal intramural pseudodiverticulosis (EIPD) is a rare, benign condition of uncertain etiology and pathogenesis, which usually presents with either progressive or intermittent dysphagia. Acute presentation with food impaction, requiring emergency esophago-gastroduodenoscopy (EGD), is rare. We report a case of EIPD presenting as food bolus impaction in an elderly black female. The patient had no previous history of dysphagia or odynophagia. Currently accepted risk factors, such as diabetes mellitus, chronic alcoholism, and reflux esophagitis, were not present in our patient. Emergency EGD established the diagnosis and also dislodged the food bolus. Histopathological evaluation of the mucosa diagnosed co-existent acute candidal infection. Medical treatment with proton pump inhibitor and azole antifungal led to resolution of her symptoms. Review of the literature revealed that stenosis, strictures, perforation, gastro-intestinal bleed, and fistula formation are potential complications of EIPD. Multiple motility abnormalities have been described but are not consistent. Treatment of the underlying inflammatory and or infectious condition is the mainstay of management of this unusual condition.
authors.affiliation: Department of Medicine, Columbia University Medical Center, Harlem Hospital Center, New York, NY, USA and Division of Gastroenterology, Department of Medicine, Columbia University Medical Center, Harlem Hospital Center, New York, NY, USA sy2394@columbia.edu.
authors.forename: Yahuza
authors.initials: Y
authors.lastname: Siba
authors.affiliation: Department of Medicine, Columbia University Medical Center, Harlem Hospital Center, New York, NY, USA and Division of Gastroenterology, Department of Medicine, Columbia University Medical Center, Harlem Hospital Center, New York, NY, USA.
authors.forename: Saritha
authors.initials: S
authors.lastname: Gorantla
authors.affiliation: Department of Medicine, Columbia University Medical Center, Harlem Hospital Center, New York, NY, USA and Division of Gastroenterology, Department of Medicine, Columbia University Medical Center, Harlem Hospital Center, New York, NY, USA.
authors.forename: Anand
authors.initials: A
authors.lastname: Gupta
authors.affiliation: Department of Medicine, Columbia University Medical Center, Harlem Hospital Center, New York, NY, USA and Division of Gastroenterology, Department of Medicine, Columbia University Medical Center, Harlem Hospital Center, New York, NY, USA.
authors.forename: Edward
authors.initials: E
authors.lastname: Lung
authors.affiliation: Department of Medicine, Columbia University Medical Center, Harlem Hospital Center, New York, NY, USA and Division of Gastroenterology, Department of Medicine, Columbia University Medical Center, Harlem Hospital Center, New York, NY, USA.
authors.forename: Joan
authors.initials: J
authors.lastname: Culpepper-Morgan
keywords: dysphagia; esophageal candidiasis; esophageal intramural pseudodiverticulosis; food impaction