Evaluation of esophageal intramural pseudo-diverticulosis using high-resolution manometry

被引:2
作者
Aimi M. [1 ]
Mikami H. [1 ]
Izumi D. [1 ]
Okimoto E. [1 ]
Tada Y. [2 ]
Mishiro T. [1 ]
Ishimura N. [1 ]
Ishihara S. [1 ]
Kinoshita Y. [1 ]
机构
[1] Second Department of Internal Medicine, Shimane University School of Medicine, 89-1 Enya-cho, Izumo-shi, 693-8501, Shimane
[2] Department of Gastroenterology, Matsue Red Cross Hospital, 200 Horo-machi, Matsue-shi, 690-8506, Shimane
关键词
Abnormal esophageal motility; Dysphagia; Esophageal diverticulum; High-resolution manometry;
D O I
10.1007/s12328-016-0672-5
中图分类号
学科分类号
摘要
Esophageal intramural pseudo-diverticulosis (EIPD) is a rare disease characterized by multiple small flask-shaped pouches in the esophageal wall, with the predominant symptom of chronic progressive or intermittent dysphagia. However, its etiology and pathogenesis remain unknown. We present a case of EIPD evaluated with high-resolution manometry in a 75-year-old man with food impaction after eating beef, who came to our emergency department. The patient experienced similar episodes three times previously, though the cause was unknown. Computed tomography (CT) findings revealed diffuse wall thickness in the upper intrathoracic esophagus, while esophagogastroduodenoscopy showed multiple small depressions and several white plaque patches, and a barium meal esophagogram showed characteristic multiple small outpouching areas. From these findings, we diagnosed the patient with EIPD. In addition, high-resolution manometry revealed strong contractions in the distal esophagus. We started an administration of isosorbide dinitrate, because abnormal esophageal motility may have been causative of the condition and development of pseudo-diverticulosis. Thereafter, the patient had a good clinical course without food impaction. Elevated intra-esophageal luminal pressure caused by abnormal esophageal motility seems to be an important factor in the pathogenesis of EIPD in some cases. © 2016, Japanese Society of Gastroenterology.
引用
收藏
页码:281 / 284
页数:3
相关论文
共 13 条
  • [1] Mendl K., McKay J.M., Tanner C.H., Intramural diverticulosis of the esophagus and Rokitansky–Aschoff sinuses in the gall-bladder, Br J Radiol, 33, pp. 496-501, (1960)
  • [2] Chino O., Makuuchi H., Kondo Y., Et al., Esophageal intramural pseudodiverticulosis treated by endoscopic balloon dilatation, Tokai J Exp Clin Med, 39, 3, pp. 137-140, (2014)
  • [3] Siba Y., Gorantla S., Gupta A., Et al., Esophageal intramural pseudodiverticulosis, a rare cause of food impaction: case report and review of the literature, Gastroenterol Rep (Oxf)., 3, 2, pp. 175-178, (2015)
  • [4] Chiba T., Iijima K., Koike T., Et al., A case of severe esophageal intramural pseudodiverticulosis whose symptoms were ameliorated by oral administration of anti-fungal medicine, Case Rep Gastroenterol., 6, 1, pp. 103-110, (2012)
  • [5] van der Pol R.J., Benninga M.A., Bredenoord A.J., Et al., Intramural pseudodiverticulosis of the esophagus: a case report, Eur J Pediatr, 172, 12, pp. 1697-1699, (2013)
  • [6] Halm U., Lamberts R., Knigge I., Et al., Esophageal intramural pseudodiverticulosis: endoscopic diagnosis and therapy, Dis Esophagus, 27, 3, pp. 230-234, (2014)
  • [7] Takeshita N., Kanda N., Fukunaga T., Et al., Esophageal intramural pseudodiverticulosis of the residual esophagus after esophagectomy for esophageal cancer, World J Gastroenterol, 21, pp. 9223-9227, (2015)
  • [8] Tyberg A., Jodorkovsky D., A Treatment Option for Esophageal Intramural Pseudodiverticulosis, ACG Case Rep J., 1, 3, pp. 134-136, (2014)
  • [9] Turan I., Ozen E., Bor S., Et al., Esophageal intramural pseudodiverticulosis associated with achalasia: an unusual endoscopic appearance, Endoscopy., 41, pp. E23-E24, (2009)
  • [10] Kuribayashi S., Iwakiri K., Kawada A., Et al., Variant parameter values-as defined by the Chicago Criteria-produced by ManoScan and a new system with Unisensor catheter, Neurogastroenterol Motil, 27, 2, pp. 188-194, (2015)