Esophagobronchial fistula resulting from esophageal intramural pseudodiverticulosis

Diffuse, intramural esophageal pseudodiverticulosis is a rare condition manifested by progressive or intermittent dysphagia. Although much controversy has arisen regarding its etiology, it is believed to be a result of the dilatation of excretory ducts of submucosal glands within the esophageal wall. The characteristic appearance on barium studies and its unique pattern on endoscopy simplify its recognition. Treatment usually centers around symptomatic relief with esophageal dilatations. Complications arising from this disorder generally are related to the dysphagia and its sequelae. Esophagobronchial fistulization has not been reported in the literature in association with intramural pseudodiverticulosis. We present a case that characterizes the salient features of this disease along with the development of an esophagobronchial communication resulting in recurrent bouts of pneumonia.