title: Esophageal Intramural Pseudodiverticulosis and Concomitant Eosinophilic Esophagitis: A Case Series.
abstract: Background. Esophageal intramural pseudodiverticulosis (EIPD) is an idiopathic benign chronic disease characterized by flask-like outpouchings of the esophageal wall. It is unknown whether there is a genuine association between EIPD and eosinophilic esophagitis (EoE). Aims. To investigate a possible relationship between EIPD and EoE. Methods. Patients with radiographic or endoscopic evidence of pseudodiverticulosis were identified from the database at a single academic center. Cases were analyzed in three areas: clinical information, endoscopic findings, and course. Results. Sixteen cases of esophageal pseudodiverticulosis were identified. Five patients had histologic evidence of eosinophilic esophagitis. Patients with EoE had pseudodiverticula in the mid-to-distal esophagus while those with EIPD had pseudodiverticula predominantly in the proximal esophagus (p < 0.001). EoE with pseudodiverticulosis occurred in younger patients (p < 0.019). Food bolus obstructions were more common in patients with EoE and pseudodiverticulosis than in EIPD (p < 0.034). Conclusions. This is the first case series supporting a potential association between EoE and pseudodiverticulosis. We also identify characteristic features of pseudodiverticulosis that may raise clinical suspicion of underlying eosinophilic esophagitis.
authors.affiliation: Division of Gastroenterology, St. Michael's Hospital, Toronto, ON, Canada.
authors.forename: Michael A
authors.initials: MA
authors.lastname: Scaffidi
authors.affiliation: Division of Gastroenterology, St. Michael's Hospital, Toronto, ON, Canada.
authors.forename: Ankit
authors.initials: A
authors.lastname: Garg
authors.affiliation: Division of Gastroenterology, St. Michael's Hospital, Toronto, ON, Canada.
authors.forename: Brandon
authors.initials: B
authors.lastname: Ro
authors.affiliation: Division of Gastroenterology, St. Michael's Hospital, Toronto, ON, Canada.
authors.forename: Christopher
authors.initials: C
authors.lastname: Wang
authors.affiliation: Division of Gastroenterology, St. Michael's Hospital, Toronto, ON, Canada.
authors.forename: Tony T C
authors.initials: TT
authors.lastname: Yang
authors.affiliation: Division of Gastroenterology, St. Michael's Hospital, Toronto, ON, Canada.
authors.forename: Ian S
authors.initials: IS
authors.lastname: Plener
authors.affiliation: Laboratory Medicine and Pathobiology, St. Michael's Hospital, Toronto, ON, Canada.
authors.forename: Andrea
authors.initials: A
authors.lastname: Grin
authors.affiliation: Department of Medical Imaging, St. Michael's Hospital, Toronto, ON, Canada.
authors.forename: Errol
authors.initials: E
authors.lastname: Colak
authors.affiliation: Division of Gastroenterology, St. Michael's Hospital, Toronto, ON, Canada.
authors.forename: Samir C
authors.identifier: 0000-0003-3392-1220
authors.initials: SC
authors.lastname: Grover
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D001249:Asthma / Q000150:complications; D002908:Chronic Disease; D003680:Deglutition Disorders / Q000209:etiology; D003876:Dermatitis, Atopic / Q000150:complications; D004936:Diverticulum, Esophageal / Q000150:complications* / Q000000981:diagnostic imaging / Q000628:therapy; D057765:Eosinophilic Esophagitis / Q000150:complications* / Q000473:pathology / Q000628:therapy; D004945:Esophagoscopy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011859:Radiography; D012307:Risk Factors