INTRAMURAL PSEUDODIVERTICULOSIS OF THE ESOPHAGUS DETECTED ON BARIUM ESOPHAGOGRAMS - INCREASED PREVALENCE IN PATIENTS WITH ESOPHAGEAL-CARCINOMA

OBJECTIVE. We tested the hypothesis that intramural pseudodiverticulos is of the esophagus is more prevalent in patients with esophageal carc inoma than in randomly selected patients who undergo esophagography fo r other indications. Such an association would prompt a careful search for carcinoma after esophageal intramural pseudodiverticulosis is fou nd. MATERIALS AND METHODS. Single- and double-contrast esophagograms o f 245 patients with esophageal carcinoma were retrospectively reviewed . A control group of 6400 esophagograms obtained for indications other than esophageal carcinoma was also reviewed. The statistical signific ance of the difference in prevalence of esophageal intramural pseudodi verticula between patients with esophageal carcinoma and the control g roup was tested using the chi-square test. The significance of differe nce between the number of esophageal intramural pseudodiverticula in p atients with esophageal dilatation and the number in those without dil atation was tested using a small-sample nonparametric test. RESULTS. I ntramural pseudodiverticulosis of the esophagus was found in 11 patien ts with esophageal carcinoma (4.5%) and in six control subjects (0.09% ). Intramural pseudodiverticulosis of the esophagus was present opposi te the tumor as well as both proximally and distally. The number of ca ses of intramural diverticulosis in patients with esophageal carcinoma and dilatation was not significantly higher than that in patients wit h carcinoma but without dilatation (p > .1). CONCLUSION. The prevalenc e of esophageal intramural pseudodiverticulosis is significantly highe r in patients with esophageal carcinoma than in patients who underwent esophagography for other indications (p < .0002). This association im plies increased risk of esophageal carcinoma in patients with intramur al pseudodiverticulosis. Periodic surveillance of patients with intram ural pseudodiverticulosis of the esophagus for esophageal carcinoma ma y be worthwhile.