Copyright
©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Endosc. Mar 16, 2022; 14(3): 183-190
Published online Mar 16, 2022. doi: 10.4253/wjge.v14.i3.183
Published online Mar 16, 2022. doi: 10.4253/wjge.v14.i3.183
Z-per-oral endoscopic myotomy as definitive prevention of a bleeding ulcer in Zenker’s diverticulum: A case report
Chonlada Krutsri, Pitichote Hiranyatheb, Preeda Sumritpradit, Pongsasit Singhatas, Pattawia Choikrua, Department of Surgery, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok 10400, Thailand
Author contributions: Krutsri C and Hiranyatheb P designed, performed and wrote the paper; Sumritpradit P and Singhatas P wrote the paper and analysed the data; Choikrau P contributed analytic tools and analysed the data.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (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: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Pitichote Hiranyatheb, FRCS, MD, Assistant Professor, Surgeon, Department of Surgery, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Ramathibodi Hospital, 270 Praram VI Road, Ratchathewi, Bangkok 10400, Thailand. pitichotch@yahoo.com
Received: October 12, 2021
Peer-review started: October 12, 2021
First decision: November 17, 2021
Revised: November 18, 2021
Accepted: February 12, 2022
Article in press: February 12, 2022
Published online: March 16, 2022
Peer-review started: October 12, 2021
First decision: November 17, 2021
Revised: November 18, 2021
Accepted: February 12, 2022
Article in press: February 12, 2022
Published online: March 16, 2022
Core Tip
Core Tip: Bleeding from ulcers in a Zenker’s diverticulum is extremely rare. Elderly patients with early symptoms of progressive dysphagia should be treated with a high index of suspicion. Risk factors include acidic pills, such as aspirin and non-steroidal anti-inflammatory drugs, that lodge themselves in the diverticulum creating an ulcer, and accumulation of food in the bottom of diverticulum leads to inflammation and subsequent ulcers. Per-oral endoscopic myotomy is a new definitive treatment for Zenker's diverticulum that can promote ulcer healing, decrease recurrent bleeding, and decrease dysphagia.