Oesophageal pseudodiverticulosis

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

It is a rare condition, found in <1% of oesophagrams. It may occur at any age, but is more common at 50-70 years old. There is a slight male predominance 2.

Associations

Intramural pseudodiverticula represent dilated excretory ducts of the deep oesophageal mucosal glands 1.

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 1,2

  • 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 oesophageal wall, as the channel to the lumen is imperceptible
  • viewed en face, may look like ulcers 3
  • intramural tracking may sometimes be seen bridging two or more pseudodiverticula 2 

Pseudodiverticular rupture with mediastinitis has been reported but is very rare 4.


Oesophageal pathology
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Article Information

rID: 12535
Section: Pathology
Synonyms or Alternate Spellings:
  • Esophageal pseudodiverticulosis
  • Oesophageal intramural pseudodiverticulosis
  • Esophageal intramural pseudodiverticulosis

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