Esophageal Perforation After Pneumatic Dilation for Achalasia: Successful Closure With an Over-the-Scope Clip

摘要

A 65-year-old woman with end-stage achalasia had persistent dysphagia, regurgitation, and weight loss despite serial botulinum toxin injections into the lower esophageal sphincter. Therefore, she had a percutaneous endoscopic gastrostomy tube placed for maintenance of nutrition and was referred to our center for further management. Pneumatic dilation with a 30-mm diameter Rigiflex balloon (Boston Scientific, MA) was performed under endoscopic and fluo-roscopic guidance. Endoscopic inspection immediately after dilation showed a 1.5-cm-long linear esophageal full-thickness perforation just proximal to the gastroesophageal junction.