Multimodal Endoscopic Management of Esophageal Perforations as a Complication of Peroral Endoscopic Myotomy for a Zenker's Diverticulum

Erlison Mauricio Daza Castro; Carlos Fernando Fuentes; Andrea Carolina Córdoba Guzmán; Diego Aponte; José Nicolás Rocha; Carlos González; Luis Carlos Sabbagh

doi:10.14309/crj.0000000000001059

Multimodal Endoscopic Management of Esophageal Perforations as a Complication of Peroral Endoscopic Myotomy for a Zenker's Diverticulum

ACG Case Rep J. 2023 Jun 10;10(6):e01059. doi: 10.14309/crj.0000000000001059. eCollection 2023 Jun.

Authors

Erlison Mauricio Daza Castro¹, Carlos Fernando Fuentes², Andrea Carolina Córdoba Guzmán¹, Diego Aponte^{2

3}, José Nicolás Rocha², Carlos González^{2

3}, Luis Carlos Sabbagh^{2

3}

Affiliations

¹ Department of Gastroenterology, Sanitas Foundation University, Colombia University Clinic, Bogotá, Colombia.
² Department of Gastroenterology, Sanitas Foundation University, Colombia University Clinic, Keralty Group, Bogotá, Colombia.
³ Department of Gastroenterology, Sanitas Foundation University, Reina Sofía Clinic, Colsanitas Clinic, Keralty Group, Bogotá, Colombia.

Abstract

Zenker's diverticulum develops because of a weakness in Killian's triangle, leading to a mucosal and submucosal herniation. Its treatment has evolved from morbid surgical interventions to safer endoscopic techniques such as peroral endoscopic myotomy (Z-POEM). Despite being a safe technique, Z-POEM is not free of complications such as perforations, bleeding, pneumoperitoneum, and pneumothorax, for which new endoscopic techniques have been developed. We present the case of a 53-year-old man taken to a Z-POEM who postoperatively presented dehiscence of the mucosotomy and a mediastinal collection, managed with a vacuum-assisted endoscopic closure device.

Keywords: Z-POEM; Zenker's diverticulum; abscess; esophageal perforation.

Publication types

Case Reports