A 46-year-old male with a history of HIV infection diagnosed in 2006 was treated with tenofovir/emtricitabine and efavirenz for 7 years, with undetectable viral load and CD4 lymphocytes smoking > 500 cib/ml.
The patient was being followed up in consultation due to mixed dysphagia, which referred to high esophageal level, especially for solid, non-progressive, 10 years of evolution.
He had presented several occasional episodes of food impaction that did not require endoscopic extraction.
She did not report odynophagia or constitutional syndrome, vomiting or heartburn.
A gastroscopy showed multiple diverticular orifices in the proximal esophagus.
Biopsies of the proximal and middle esophagus were taken and the mucosa was ruled out by eosinophils.
Since the endoscopic findings did not justify the patient's clinical status, esophageal manometry and EGD were requested to complete the study.
Esophageal pHmetry and mannequin showed pathological acid reflux, in addition to a nonspecific mild esophageal motor disorder.
There was also a hypotensive cricopharyngeal with normal swallowing component and a normotensive lower esophageal sphincter with incomplete and incoordinated malformations.
The EGD showed images compatible with intramural esophageal pseudosis that led to the diagnosis of the patient and the cause of his dysphagia.
