Abstract
A 67-year-old man with a long history of achalasia underwent pneumatic dilation of
the lower esophageal sphincter due to increasing dysphagia. During the procedure,
a small perforation of the thoracic part of the distal esophagus occurred. Since the
rupture was small, well-confined, and detected immediately, the lesion was closed
using endoscopically applied metallic clips. The patient did very well, and a contrast
swallow three days later showed no leakage of the esophagus. This procedure has not
yet been described for the esophagus in the literature, but it may be considered in
selected cases of small and well-defined instrumental perforations.
