Research Article Esophageal Intramural Pseudodiverticulosis and Concomitant Eosinophilic Esophagitis: A Case Series Michael A. Scaffidi, 1 Ankit Garg, 1 Brandon Ro, 1 Christopher Wang, 1 Tony T. C. Yang, 1 Ian S. Plener, 1 Andrea Grin, 2 Errol Colak, 3 and Samir C. Grover 1 1 Division of Gastroenterology, St. Michael’s Hospital, Toronto, ON, Canada 2 Laboratory Medicine and Pathobiology, St. Michael’s Hospital, Toronto, ON, Canada 3 Department of Medical Imaging, St. Michael’s Hospital, Toronto, ON, Canada Correspondence should be addressed to Samir C. Grover; samir.grover@utoronto.ca Received 8 January 2016; Revised 16 June 2016; Accepted 26 July 2016 Academic Editor: Michael Beyak Copyright © 2016 Michael A. Scafdi et al. Tis is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Background. Esophageal intramural pseudodiverticulosis (EIPD) is an idiopathic benign chronic disease characterized by fask- like outpouchings of the esophageal wall. It is unknown whether there is a genuine association between EIPD and eosinophilic esophagitis (EoE). Aims. To investigate a possible relationship between EIPD and EoE. Methods. Patients with radiographic or endoscopic evidence of pseudodiverticulosis were identifed from the database at a single academic center. Cases were analyzed in three areas: clinical information, endoscopic fndings, and course. Results. Sixteen cases of esophageal pseudodiverticulosis were identifed. Five patients had histologic evidence of eosinophilic esophagitis. Patients with EoE had pseudodiverticula in the mid- to-distal esophagus while those with EIPD had pseudodiverticula predominantly in the proximal esophagus ( < 0.001). EoE with pseudodiverticulosis occurred in younger patients ( < 0.019). Food bolus obstructions were more common in patients with EoE and pseudodiverticulosis than in EIPD ( < 0.034). Conclusions. Tis is the frst case series supporting a potential association between EoE and pseudodiverticulosis. We also identify characteristic features of pseudodiverticulosis that may raise clinical suspicion of underlying eosinophilic esophagitis. 1. Introduction Esophageal intramural pseudodiverticulosis (EIPD) is an idiopathic benign disease characterized by fask-like out- pouchings of the esophageal wall distinguished by dilatation and infammation of excretory ducts within the submucosal esophageal glands [1]. It is a rare condition with fewer than 250 cases reported [2]. Symptoms include progressive dys- phagia or odynophagia and rarely gastrointestinal bleeding. Te diagnosis is typically made by either esophagoscopy or barium esophagography. Proposed risk factors include alco- hol and tobacco use [1] and potential associated comorbidi- ties include gastroesophageal refux, esophageal candidiasis, diabetes mellitus, chronic liver disease, and malnutrition [3]. Tere have been three case reports of concomitant eosinophilic esophagitis (EoE) with pseudodiverticulosis [4]. While both conditions present with dysphagia and result in esophageal mucosal change and stricturing [1, 5], the patho- logic hallmark of EoE is mucosal eosinophilia, in contrast to the alteration of the submucosal esophageal glands in EIPD [6, 7]. Given the paucity of data, it is unknown whether there is a genuine association between EIPD and EoE. Tis case series evaluates the risk factors, medical comorbidities, and clinical and investigative fndings among patients with esophageal pseudodiverticulosis, in order to evaluate a possi- ble relationship between EIPD and EoE. 2. Methods Te radiographic and endoscopic patient databases were searched for records of patients with fndings of esophageal pseudodiverticulosis between May 2000 and October 2015, at St. Michael’s Hospital, a gastroenterology tertiary care Hindawi Publishing Corporation Canadian Journal of Gastroenterology and Hepatology Volume 2016, Article ID 1761874, 5 pages http://dx.doi.org/10.1155/2016/1761874