Endoskopie heute 2011; 24 - FV16
DOI: 10.1055/s-0030-1271264

Pseudodiverticulosis of the esophagus- value of esophageal manometry as diagnostic approach

JP Radtke 1, D Müller-Gerbes 1, M Kreutzträger 2, M Brockmann 3, A Goßmann 4, A Dormann 1
  • 1Department of Internal Medicine, Kliniken der Stadt Köln gGmbH, Krankenhaus Holweide, Cologne, Germany
  • 2Medical Faculty of Johann-Wolfgang Goethe University of Frankfurt, Frankfurt am Main, Germany
  • 3Department of Pathology, Kliniken der Stadt Köln gGmbH, Krankenhaus Merheim, Cologne, Germany
  • 4Department of Radiology, Kliniken der Stadt Köln gGmbH, Krankenhaus Merheim, Cologne, Germany

Background: Esophageal intramural pseudodiverticulosis is a rare benign disease characterized by dilatation of submucosal glands of which just 250 cases have been reported.

Case report: A 68-year-old man presented with a two-year history of dysphagia, which had gradually become worse in recent months. Esophageal manometry demonstrated simultaneous low?amplitude peristalsis in the esophageal body and rigor of the esophageal septum. Endoscopy showed stenosis of the upper thoracic esophagus with multiple tiny outpouchings along the region of stenosis parallel to the long axis.

The patient underwent balloon dilatation of the stenosis and dysphagia resolved.

Discussion: Due to the fact that esophageal pseudodiverticulosis is a rare disease, there is no evidented ‘gold standard’ in the diagnostic of that functional disorder. Most pseudodiverticuloses are evaluated by endoscopy done in case of the clinical sign of dysphagia. As further diagnostic method most gastroenterologists prefer a contrast swallow with barium-sulfate. Manometry and endoscopic ultrasound are of seldom usage. Concerning to the side effects of barium-sulfate like aspiration and following aspiration pneumonia we rather performed a manometry and postulate esophageal manometry as an effective detection method for one of the first published appearances.