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A patient with oesophageal intramural pseudodiverticulosis (believed to be the first case reported in the southern African literature) is described and the literature is reviewed. Although the pathogenesis of the condition remains uncertain, reflux oesophagitis, increased intra-oesophageal pressure and chronic monilial oesophagitis may be important antecedents. The characteristic histopathological findings include dilatation of the excretory ducts of the submucosal oesophageal mucous glands with periductal inflammation. The appearance of multiple flask-shaped outpouchings on barium studies is diagnostic. More recently, computed tomography has been shown to be useful in confirming the diagnosis.