Clinical and endoscopic characteristics of diffuse esophageal intramural pseudo-diverticulosis.


Journal

Esophagus : official journal of the Japan Esophageal Society
ISSN: 1612-9067
Titre abrégé: Esophagus
Pays: Japan
ID NLM: 101206627

Informations de publication

Date de publication:
10 2020
Historique:
received: 26 09 2019
accepted: 24 02 2020
pubmed: 13 3 2020
medline: 14 8 2021
entrez: 13 3 2020
Statut: ppublish

Résumé

With 250 published cases worldwide, diffuse esophageal intramural pseudo-diverticulosis (DEIPD) is a poorly understood disease. The aim of this study was to determine the prevalence of DEIPD in our own population, identify risk factors and clinical symptoms, and characterize its typical endoscopic signs. Retrospective search in our center's endoscopic and clinical database. Reviewing of all cases by re-examining stored endoscopic photographs. Reviewing of all cases regarding age, sex, risk factors, comorbidities, histology, and clinical symptoms. In a population of 150.000 we found 21 cases of DEIPD. Mean age was 56 ± 10 years. 86% were males, 76% had alcohol abuse, 57% had nicotine abuse, 38% had arteriosclerosis, 33% had COPD, 29% had malignancies, 24% had liver cirrhosis, 19% had impaired kidney function, and 15% had diabetes. Dysphagia was present in 62% and food bolus impaction (single or repeated) in 48%. Endoscopically, 95% of patients had multiple (> 4), small (0.25-2.5 mm) pseudodiverticle openings in the esophageal wall. In 62%, openings were aligned longitudinally. 86% showed edematous swelling of mucosa ("frosted glass look"), 76% showed a fine-grained pattern of small (10-100 µm) red dots ("faux uni pattern"), and 76% had a rigid, narrow lumen with multiple rings ("trachealization"). With a prevalence of approximately 5 to 50/100.000, DEIPD may be more frequent than previously estimated. It preferably affects middle-aged male alcoholics. Key symptoms are chronic dysphagia and food impaction. Typical endoscopic findings are multiple, small, longitudinally aligned pseudodiverticle openings, frosted glass look, faux uni pattern, and trachealization of the esophagus.

Identifiants

pubmed: 32162106
doi: 10.1007/s10388-020-00729-6
pii: 10.1007/s10388-020-00729-6
pmc: PMC7497296
doi:

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

492-501

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Auteurs

Florian Hentschel (F)

Center for Internal Medicine II, Brandenburg Medical School Theodor Fontane, Brandenburg an der Havel, Germany. f.hentschel@klinikum-brandenburg.de.
Zentrum für Innere Medizin II, Hochschulklinikum Brandenburg der MHB, Hochstr. 29, 14770, Brandenburg an der Havel, Germany. f.hentschel@klinikum-brandenburg.de.

Stefan Lüth (S)

Center for Internal Medicine II, Brandenburg Medical School Theodor Fontane, Brandenburg an der Havel, Germany.

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