SUBMUCOSAL TUNNELLING AND ENDOSCOPIC MARSUPIALISATION AS A SAFE AND EFFECTIVE TREATMENT OF ESOPHAGEAL BRONCHOGENIC CYST (EBC)

61-y-male with dysphagia;CECT–esophageal sub-epithelial lesion(SEL);EGD–distal esophageal SEL-anterior wall at 29 – 35cm;EUS–well circumscribed solid hypoechoic lesion-layer 3(40mm diameter).STER planned assuming esophageal leiomyoma. FNA not performed-could compromise STER due to resultant submucosal(SM)fibrosis.Procedure–supine,endotracheal intubation;CO2 insufflation;mucosal incision and SM tunnelling;significant SM fibrosis;inadvertent puncture of cyst with drainage of turbid fluid-suspicion of bronchogenic/duplication cyst;intra-cystic papillary projections–biopsied;therefore procedural plan changed–deroofing of cyst cavity followed by marsupialisation–cyst lining clipped to esophageal mucosa using multiple endoclips;mucosal incision closed.Contrast swallow–no leak;Oral diet after 24hours.HPE–pseudo-stratified ciliated columnar epithelium s/o bronchogenic cyst.4-week f/u EGD–cyst epithelialisation, healed incision site;asymptomatic at 3-month f/u.

Publication History

Article published online:
14 April 2022