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1/3. Alkali ingestion predisposes to developing giant mid-esophageal pulsion diverticulum - a report of a medical rarity.

    Pulsion diverticulae of the mid-esophagus with unknown etiology are usually asymptomatic and therefore considered incidental findings on chest x-rays, barium swallows, or endoscopic procedures. diagnosis is often delayed due to the rarity of clinical symptoms. The clinical, radiological, etiological and surgical features in a patient with extraordinary symptomatic giant mid-esophageal pulsion diverticulum with history of alkali ingestion are presented here. Alkali injury may yield asymptomatic strictures and/or acquired weaknesses of the esophageal wall, both of which are known to lead to the formation of this giant malady. Putative pathomechanism and suggested therapy including diverticulectomy is proposed in this communication. ( info)

2/3. Esophageal intramural pseudodiverticulosis with esophageal strictures successfully treated with dilation therapy.

    We report a rare case of esophageal intramural pseudodiverticulosis with esophageal strictures. barium esophagogram demonstrated multiple flask-shaped diverticula out of the esophageal wall with comprehensive luminal stenosis involving the proximal 8 cm and distal 4 cm of the esophagus. Chest computed tomographic scan demonstrated round wall thickening and several intramural gas collections of the proximal esophagus. endoscopy revealed a fibrotic stricture and multiple small orifices of pseudodiverticula with mild inflammatory changes. biopsy specimens showed active chronic inflammatory changes of the mucosa with candidiasis. Dysphagia improved dramatically with esophageal dilation. However, the tiny diverticula did not resolve after treatment. ( info)

3/3. Esophageal intramural pseudodiverticulosis complicated by pneumomediastinum.

    We report a rare case of esophageal intramural pseudodiverticulosis with perforation of the esophagus. A 32-year-old male presented with acute thoracal pain after a period of vomiting. Computed tomography revealed an important amount of mediastinal free air and small outpouchings in the wall of the esophagus. During the following thoracic surgery procedure no macroscopic site of rupture could be identified. Pseudodiverticulosis was detected during a barium swallow exam of the esophagus 4 weeks later. ( info)

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