Endoscopic treatment for dysphagia caused by mid-esophageal diverticulum and diffuse esophageal spasm: A case report.

BACKGROUND

A mid-esophageal diverticulum is an outpouching located in the midsection of the esophagus, posterior to the bifurcation of the right and left bronchi. The condition is characterized by an outward protrusion of the inner esophageal wall. Mid-esophageal diverticula are relatively rare and may coexist with diffuse esophageal spasm. However, the potential esophageal motility disorders associated with these lesions are frequently overlooked in clinical practice. The use of endoscopic interventions may offer a novel approach for the alleviation of dysphagia associated with this condition.

CASE SUMMARY: We present a case of a 74-year-old woman with dysphagia, diagnosed with mid-esophageal diverticulum and diffuse esophageal spasm. Due to her physical condition, submucosal tunneling endoscopic septum division (STESD) was initially performed for the diverticulum. One month later, the esophageal spasm was treated using per-oral endoscopic myotomy (POEM). This combined treatment significantly improved her dysphagia, and she was discharged.

CONCLUSION

STESD and POEM are effective and safe for the treatment of dysphagia caused by mid-esophageal diverticula with diffuse esophageal spasm.