Intramurale Pseudodivertikulose des Ösophagus

Esophageal intramural pseudodiverticulosis in barium swallow

Esophageal

intramural pseudodiverticulosis in barium swallow

Esophageal intramural pseudodiverticulosis characterized by barium esophagography: a case report. Barium oesophagram. (A) There are numerous barium-filled diverticula of the mid- and lower esphagus. (B) There is lack of distension of the mid-esophagus, thus indicating the presence of a stricture.

Esophageal

intramural pseudodiverticulosis characterized by barium esophagography: a case report. Barium oesophagram. (A) There are numerous barium-filled diverticula of the mid- and lower esphagus. (B) There is lack of distension of the mid-esophagus, thus indicating the presence of a stricture.

jmedicalcasereports.biomedcentral.com • CC-by-2.0

A rare cause of dysphagia due to esophageal intramural pseudodiverticulosis: a case report and review of literature. Numerous small submucosal collections of contrast throughout the esophagus

A rare cause

of dysphagia due to esophageal intramural pseudodiverticulosis: a case report and review of literature. Numerous small submucosal collections of contrast throughout the esophagus

bmcgastroenterol.biomedcentral.com • CC-by-4.0

Endoscopic image of esophageal intramural pseudodiverticulosis.

Endoscopic

image of esophageal intramural pseudodiverticulosis.

Wikipedia • CC BY-SA 3.0

Esophageal intramural pseudodiverticulosis characterized by barium esophagography: a case report. Endoscopic image of the esophagus. The pseudodiverticular orifices appear as multiple erythematous macules on the surface of the esophagus.

Esophageal

intramural pseudodiverticulosis characterized by barium esophagography: a case report. Endoscopic image of the esophagus. The pseudodiverticular orifices appear as multiple erythematous macules on the surface of the esophagus.

jmedicalcasereports.biomedcentral.com • CC-by-2.0

Radiopaedia • CC-by-nc-sa 3.0 • de

siehe auch

Ösophaguskarzinom
Ösophagusstrikur
Moniliasis
oesophagitis

Esophageal intramural pseudodiverticulosis is an uncommon condition in which there are numerous small outpouchings within the esophageal wall.

Epidemiology

It is a rare condition, found in <1% of oesophagrams. It may occur at any age, but is more common between 50 and 70 years. There is a slight male predominance .

Associations

esophageal strictures: present in 90% of patients
gastroesophageal reflux
esophageal candidiasis
chronic esophagitis
esophageal carcinoma

Pathology

Intramural pseudodiverticula represent dilated excretory ducts of the deep esophageal mucosal glands .

Radiographic features

Fluoroscopy

Barium swallow examination is the study of choice, as the ductal orifices may be too small to be seen on endoscopy. Pseudodiverticula are better seen with a single contrast examination than with a double contrast, thin barium examination .

numerous, tiny (1-4 mm), flask-shaped outpouchings
may be diffusely distributed or clustered
clustering may occur next to peptic strictures
viewed in profile, often appear “floating” next to the esophageal wall, as the channel to the lumen is imperceptible
viewed en face, may appear as ulcers
intramural tracking may sometimes be seen bridging two or more pseudodiverticula

Treatment and prognosis

The treatment of esophageal pseudodiverticulosis is dependent on symptoms displayed and accompanying conditions . Around 10% of patients do no require treatment . The use of proton pump inhibitors can help relieve symptoms of esophagitis. If esophageal strictures are present, the use of endoscopic dilatation helps improve treatment response .

Pseudodiverticular rupture with resultant mediastinitis has been reported but is very rare .