Introduction
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Estimating incidence and prevalence of DEIPD in our own pre-selected collective of inpatients and outpatients who underwent esophago-gastro-duodenoscopy (EGD)
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Extrapolate these numbers to the prevalence in the overall population.
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Verify or falsify suspected risk factors for DEIPD
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Describe “typical” DEIPD patients regarding age, sex, and comorbidities
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Assess frequency and severity of typical symptoms
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Systematically describe endoscopic criteria for a definite diagnosis.
Methods
PubMed and database search
Endoscopy
Histology
Statistics
Results
Epidemiology, risk factors, additional diagnoses
Symptoms
Patient | Age | Sex | Dysphagia, odynophagia | Chest pain | Regurgitation, vomiting | Weight loss | Bolus impaction (times) |
---|---|---|---|---|---|---|---|
1 | 64 | m | + | 0 | 0 | 0 | + (2) |
2 | 55 | m | 0 | 0 | 0 | 0 | 0 |
3 | 44 | m | 0 | 0 | 0 | 0 | 0 |
4 | 61 | m | 0 | + | 0 | 0 | 0 |
5 | 72 | m | + | 0 | 0 | + | + (1) |
6 | 56 | m | + | + | 0 | 0 | 0 |
7 | 56 | m | + | 0 | 0 | + | + (3) |
8 | 55 | f | + | 0 | 0 | 0 | + (2) |
9 | 54 | m | + | 0 | 0 | + | + (1) |
10 | 31 | m | + | 0 | + | + | 0 |
11 | 77 | m | + | 0 | 0 | 0 | 0 |
12 | 52 | m | 0 | 0 | 0 | 0 | + (1) |
13 | 50 | m | 0 | 0 | + | 0 | 0 |
14 | 55 | m | + | 0 | 0 | + | + (1) |
15 | 58 | m | 0 | 0 | 0 | + | 0 |
16 | 58 | m | + | + | 0 | 0 | + (5) |
17 | 53 | m | + | 0 | 0 | 0 | + (1) |
18 | 84 | f | + | 0 | + | + | 0 |
19 | 51 | m | + | 0 | 0 | 0 | + (1) |
20 | 63 | f | 0 | 0 | 0 | 0 | 0 |
21 | 57 | m | 0 | 0 | 0 | + | 0 |
Total | 13 | 3 | 3 | 8 | 10a | ||
% | 62 | 14 | 14 | 38 | 48a |
Visits, procedures, and hospital stay
Endoscopic features
Patient No. | Number of EGD procedures | More than 4 diverticle openings | Openings aligned longitudinally | Frosted glass look | Faux uni pattern | Macroscopic candidosis | Multiple rings | Single ring |
---|---|---|---|---|---|---|---|---|
1 | 4 | + | + | + | + | 0 | + | + |
2 | 5 | + | 0 | + | + | 0 | 0 | 0 |
3 | 2 | + | + | + | 0 | 0 | + | 0 |
4 | 4 | + | + | + | + | + | + | + |
5 | 7 | + | 0 | + | 0 | + | + | + |
6 | 10 | + | 0 | + | + | + | + | + |
7 | 5 | + | + | 0 | + | 0 | + | 0 |
8 | 5 | + | + | + | + | 0 | + | 0 |
9 | 1 | + | + | + | 0 | 0 | + | + |
10 | 2 | + | + | + | + | 0 | + | 0 |
11 | 12 | + | + | + | + | + | + | + |
12 | 5 | 0 | 0 | + | + | 0 | 0 | + |
13 | 2 | + | + | + | + | + | + | + |
14 | 5 | + | 0 | + | + | + | + | + |
15 | 1 | + | + | + | 0 | 0 | 0 | + |
16 | 6 | + | + | + | + | + | + | + |
17 | 2 | + | + | + | + | + | + | + |
18 | 1 | + | 0 | + | + | 0 | 0 | 0 |
19 | 1 | + | 0 | + | + | + | + | + |
20 | 2 | + | + | 0 | + | 0 | 0 | 0 |
21 | 1 | + | + | 0 | 0 | 0 | + | 0 |
Total | 83 | 20 | 14 | 18 | 16 | 9 | 16 | 13 |
% | 95 | 67 | 86 | 76 | 43 | 76 | 62 |
Histology
Discussion
Epidemiology
Risk factors, symptoms
Endoscopy
Histology
Conclusion
• 5 or more small (0.25–5 mm) pseudodiverticle openings |
• Openings aligned longitudinally |
• Edematous swelling of mucosa—“frosted glass look” |
• Fine-grained spotty reddening of mucosa—“faux uni pattern” |
• Multiple rings, rigid esophagus (“trachealization”) |
• Distal third not more affected than rest of esophagus |
• No other cause for diverticles (Zenker’s, pulsion diverticle, connective tissue disorders, …) |