Abstract

Esophageal intramural pseudodiverticulosis (EIPD) is a rare disease with only about 200 reported cases. It is characterized by multiple flask-shaped outpouchings of the esophageal wall. These lesions are pathologically dilated and inflamed excretory ducts of the submucosal oesophageal glands. Complications include esophageal stricture, bleeding, infections and even perforation. Diagnosis of EIPD is challenging due to lack of awareness of this uncommon disease. The small outpouchings are also likely to be missed on endoscopy. Barium oesophagogram is considered a more sensitive diagnostic modality. We present a rare case of EIPD complicated with esophageal stricture in the upper third of the oesophagus. The studied 78- year- old male with dysphagia had a previous history of gastro-oesophageal reflux disease and chronic alcohol abuse, which are considered as EIPD risk factors. Pseudodiverticulosis was detected on the barium esophagogram as well as on gastroscopy. The stricture was dilated endoscopically for symptomatic relief. He was prescribed proton pump inhibitors and was advised to abstain from alcohol. Currently there are no guidelines for surveillance of these patients, although some studies suggest the possibility of development of carcinoma. Futher studies are required to clarify the ethiopathogenesis, and treatment options, and the value of surveillance of EIPD.