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Updated: Oct 5, 2025
04:05
Endoscopic Vacuum Therapy for the Treatment of Anastomotic Leakage after Total Gastrectomy with Esophagojejunostomy
Published on: August 22, 2025
111
New Endoscopic Solutions in Managing Phlegmonous Esophagitis
Ana L Santos1,2, João Santos-Antunes1,2, Rui Morais1,2
1Gastroenterology Department, Centro Hospitalar Universitário de São João, Porto, Portugal.
Digestive Diseases (Basel, Switzerland)
|January 26, 2022
Summary
This study presents a successful minimally invasive endoscopic treatment for a complex esophageal perforation complicated by gastric wall involvement. Endoscopic vacuum therapy effectively resolved the perforation, allowing the patient
Area of Science:
- Gastroenterology and Endoscopy
- Minimally Invasive Surgery
- Therapeutic Endoscopy
Background:
- Esophageal perforation is a serious condition requiring prompt management.
- Complex cases involving adjacent organ structures pose significant treatment challenges.
- Minimally invasive endoscopic techniques are increasingly explored for esophageal pathologies.
Observation:
- A 48-year-old female presented with symptoms suggestive of esophageal and gastric compromise.
- Computed tomography (CT) and upper endoscopy (UE) revealed esophageal perforation with gastric wall thickening and bulging.
- Initial internal esophageal drainage (IED) provided temporary relief but was insufficient.
Findings:
- A staged endoscopic approach, including IED and endoscopic vacuum therapy (EVT), was successfully employed.
- Dual-knife and Needle-Cut technologies facilitated targeted drainage of purulent material.
- EVT with esophageal sponge placement led to the resolution of the esophageal perforation and improved gastric wall integrity.
Implications:
- This case demonstrates the efficacy of a combined endoscopic strategy for complex esophageal perforations.
- Minimally invasive endoscopic interventions, including EVT, offer a viable alternative to surgery.
- Successful treatment resulted in complete patient recovery and normal oral intake.
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