Treatment of an esophageal perforation in a high-risk elderly patient: A novel use of a through-the-scope suturing system

Abstract Text In this case a 90 year old patient suffered an iatrogenic esophageal perforation during intubation attempt for elective surgery. She was diagnosed with a 3 cm tear just below the upper esophageal sphincter. Due to her high surgical risk and high morbidity associated with open surgical exploration, we offered a novel approach using the X-Tack device (Apollo endosurgery, Austin TX). We placed the tacks 3mm from the defect margin, distal to proximal. Defect closure was confirmed by later inssuflation and fluoroscopy. There was no apperent infection in the neck or mediastinum and no further intervention was needed for source control. Unfortunately the patient deceased on POD 28 due to ventilator pneumonia [1] [2] [3] [4] [5] [6] [7] [8] [9].