Flexible Endoscopic Treatment of Esophageal Diverticulum: A Case Report

Abstract

BackgroundIn the past, surgical resection was the only treatment available for esophageal diverticulum. Minimally invasive endoscopic treatment of esophageal diverticulum has become more and more popular in recent years. We reported a case of transoral endoscopic resection of esophageal diverticulum and crestectomy, which had a similar effect to surgery and retained the physiological function of the esophagus. It has the advantages of short procedure time, short hospital stay, and good long-term prognosis.Case presentationA 67-year-old gentleman presented with persistent dysphagia and repeated nausea and vomiting for 2 years. Combined with chest CT, barium esophagography and esophagogastroduodenoscopy, the diagnosis was a mid-esophageal diverticulum. After discussion and communication, the patient underwent oral endoscopic esophageal diverticulectomy. During the operation, the weak area of the bottom muscle layer of the diverticulum was completely removed, and the crest of the diverticulum was cut off, and the kiss suture was performed with titanium clips to reduce tension. After the operation, the right pleural effusion occurred and the lung infection was aggravated, and the right pleural drainage tube was placed to relieve the symptoms. An 18*100mm fully covered metal stent was placed under a gastroscope. Place the duodenal nutrition tube and the gastric tube drainage tube for vacuum suction. After a long period of fasting, enteral nutrition support, adequate postoperative drainage treatment and antibiotic treatment eventually l resulted in full recovery without recurrence.ConclusionThe selection of treatment for esophageal diverticulum needs to refer to many factors. For the middle esophageal diverticulum, especially those with large diverticulum sac and small mouth, and those who have indications for surgery, in addition to selective surgery and conventional endoscopic surgery, you can also try endoscopic diverticulectomy and crestectomy.