Oesophageal dissection after thrombolytic treatment for myocardial infarction.

A 62 year old woman admitted with a history suggesting acute myocardial infarction had thrombolytic treatment with anisoylated plasminogen-streptokinase activator complex, which resulted in submucosal haemorrhage in the oesophagus; this caused dissection of the wall of the oesophagus and complete dysphagia. The haematoma resolved spontaneously, leaving behind a diverticulum, with reduced peristalsis and delayed emptying but no obstruction.

Corrosive acid-induced esophageal intramural pseudodiverticulosis. A study of 14 patients.

Esophageal intramural pseudodiverticulosis (EIP) is a rare disease, characterized by multiple, small flask-shaped diverticula in the esophageal wall, and best demonstrated on single-contrast barium examination. Though the condition is often associated with reflux esophagitis, Candida esophagitis, and esophageal dysmotility, corrosive-acid injury is not a commonly recognized cause. In a radiological study involving 59 patients with sequelae of corrosive-acid injury of the upper gastrointestinal (GI) tract, evaluated over a 5-year period, 14 cases (23.7%) of EIP were found. Esophageal stricture was a constant association; the diverticula tended to involve either the entire length of the stricture or its upper part. There was, however, no correlation between the length of the stricture and number of diverticula (p greater than 0.05). Endoscopic dilatation resulted in relief of dysphagia, and the diverticula regressed in number of disappeared altogether. Our experience suggests that EIP is a common sequelae of esophageal acid injuries, and that diverticula tend to form at the site of initial contact between acid and susceptible esophageal mucosa. Stricture dilatation leads to reduction or total disappearance of the diverticula.

Intramural pseudodiverticulosis of the esophagus in corrosive strictures: report of three cases.

First described in 1960, esophageal intramural pseudodiverticulosis (EIPD) is a rare disease characterized by narrow-necked diverticuli confined to the esophageal wall. The cause is debatable, but esophageal strictures commonly accompany this entity. The association with EIPD of strictures caused by corrosives has been reported only once to date. We describe three additional examples.

Pseudodiverticula secondary to injection sclerotherapy.

The spectrum of complications encountered after injection sclerotherapy span esophageal, extraesophageal, and systemic sequelae of the sclerosing process. We report a case of pseudodiverticula secondary to sclerotherapy, a hitherto unreported complication of this modality.