Tanaka S, Toyonaga T, Ohara Y, Yoshizaki T, Kawara F, Ishida T, Hoshi N, Morita Y, Azuma T. Esophageal diverticulum exposed during endoscopic submucosal dissection of superficial cancer. World J Gastroenterol 2015; 21(10): 3121-3126 [PMID: 25780314 DOI: 10.3748/wjg.v21.i10.3121]
Corresponding Author of This Article
Shinwa Tanaka, MD, PhD, Department of Endoscopy, Kobe University, 7-5-1 Chuo-ku, Kusunoki-cho, Kobe, Hyogo 650-0017, Japan. tanakas@med.kobe-u.ac.jp
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Shinwa Tanaka, Takashi Toyonaga, Tetsuya Yoshizaki, Fumiaki Kawara, Department of Endoscopy, Kobe University, Hyogo 650-0017, Japan
Yoshiko Ohara, Tsukasa Ishida, Namiko Hoshi, Yoshinori Morita, Takeshi Azuma, Division of Gastroenterology, Department of Internal Medicine, Graduate School of Medicine, Kobe University, Hyogo 650-0017, Japan
Author contributions: Tanaka S designed the study and wrote the manuscript; Ohara Y, Yoshizaki T, Kawara F, Ishida T and Hoshi N contributed to the manuscript revision; Morita Y, Toyonaga T and Azuma T contributed to the literature review and manuscript editing.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Shinwa Tanaka, MD, PhD, Department of Endoscopy, Kobe University, 7-5-1 Chuo-ku, Kusunoki-cho, Kobe, Hyogo 650-0017, Japan. tanakas@med.kobe-u.ac.jp
Telephone: +81-78-3826305 Fax: +81-78-3826309
Received: June 1, 2014 Peer-review started: June 3, 2014 First decision: June 27, 2014 Revised: July 15, 2014 Accepted: September 5, 2014 Article in press: September 5, 2014 Published online: March 14, 2015
Abstract
Endoscopic submucosal dissection (ESD) is now widely accepted as a strategy to treat superficial esophageal neoplasms. The rate of adverse events, such as perforation, has been decreasing with the improvement of devices and techniques. In this paper, we report a case of esophageal cancer that had a diverticulum under cancerous epithelium. The diverticulum was not detected during preoperative examination, and led to perforation during the ESD procedure. Our case shows that, although rare, some diverticula can exist underneath the mucosal surface without obvious depression. If there is any sign of hidden diverticula during ESD, surgeons should proceed with caution or, depending on the case, the procedure should be discontinued to avoid adverse events.
Core tip: We report a case of esophageal cancer with a diverticulum in a patient who underwent endoscopic submucosal dissection (ESD). Although most esophageal diverticula can be diagnosed by endoscopy or computed tomography scans, the diverticulum in this case was not detected by these examinations before ESD, and led to perforation during the ESD procedure. This is a rare case; however, we should be aware that there could be diverticula without obvious depression.
