Liu XR, Chen XZ, Fan MW, Zhang SH, Shi N, Liu CX, Chen Y, Wang XM. Endoscopic treatment for dysphagia caused by mid-esophageal diverticulum and diffuse esophageal spasm: A case report. World J Gastrointest Endosc 2025; 17(11): 111770 [PMID: 41256297 DOI: 10.4253/wjge.v17.i11.111770]
Corresponding Author of This Article
Xue-Min Wang, Department of Gastroenterology, Binzhou Medical University Hospital, No. 661 Huanghe 2nd Road, Binzhou 256603, Shandong Province, China. wangxuemin116@163.com
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Medicine, Research & Experimental
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Case Report
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This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (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: http://creativecommons.org/licenses/by-nc/4.0/
Nov 16, 2025 (publication date) through Nov 21, 2025
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World Journal of Gastrointestinal Endoscopy
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Liu XR, Chen XZ, Fan MW, Zhang SH, Shi N, Liu CX, Chen Y, Wang XM. Endoscopic treatment for dysphagia caused by mid-esophageal diverticulum and diffuse esophageal spasm: A case report. World J Gastrointest Endosc 2025; 17(11): 111770 [PMID: 41256297 DOI: 10.4253/wjge.v17.i11.111770]
World J Gastrointest Endosc. Nov 16, 2025; 17(11): 111770 Published online Nov 16, 2025. doi: 10.4253/wjge.v17.i11.111770
Endoscopic treatment for dysphagia caused by mid-esophageal diverticulum and diffuse esophageal spasm: A case report
Xin-Ru Liu, Xue-Zhi Chen, Ming-Wei Fan, Shu-Hui Zhang, Ning Shi, Cheng-Xia Liu, Yan Chen, Xue-Min Wang
Xin-Ru Liu, Xue-Zhi Chen, Ming-Wei Fan, Shu-Hui Zhang, Ning Shi, Yan Chen, Xue-Min Wang, Department of Gastroenterology, Binzhou Medical University Hospital, Binzhou 256603, Shandong Province, China
Cheng-Xia Liu, Department of Gastroenterology and Hepatology, Binzhou Medical University Hospital, Binzhou 256603, Shandong Province, China
Co-first authors: Xin-Ru Liu and Xue-Zhi Chen.
Author contributions: Liu XR and Chen XZ contributed to manuscript writing and editing, and data collection; Fan MW, Zhang SH, Shi N, Liu CX and Chen Y contributed to data analysis; Wang XM contributed to conceptualization and supervision; all authors have read and approved the final manuscript.
Supported by Natural Science Foundation of Shandong Province, No. 81700472; Clinical+X Project Fund of Binzhou Medical College, No. BY2021LCX11; and Binzhou Medical University Science and Technology Program Projects, No. BY2019KJ13.
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 to disclose.
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: Xue-Min Wang, Department of Gastroenterology, Binzhou Medical University Hospital, No. 661 Huanghe 2nd Road, Binzhou 256603, Shandong Province, China. wangxuemin116@163.com
Received: July 9, 2025 Revised: August 22, 2025 Accepted: October 11, 2025 Published online: November 16, 2025 Processing time: 128 Days and 18.3 Hours
Abstract
BACKGROUND
A mid-esophageal diverticulum is an outpouching located in the midsection of the esophagus, posterior to the bifurcation of the right and left bronchi. The condition is characterized by an outward protrusion of the inner esophageal wall. Mid-esophageal diverticula are relatively rare and may coexist with diffuse esophageal spasm. However, the potential esophageal motility disorders associated with these lesions are frequently overlooked in clinical practice. The use of endoscopic interventions may offer a novel approach for the alleviation of dysphagia associated with this condition.
CASE SUMMARY
We present a case of a 74-year-old woman with dysphagia, diagnosed with mid-esophageal diverticulum and diffuse esophageal spasm. Due to her physical condition, submucosal tunneling endoscopic septum division (STESD) was initially performed for the diverticulum. One month later, the esophageal spasm was treated using per-oral endoscopic myotomy (POEM). This combined treatment significantly improved her dysphagia, and she was discharged.
CONCLUSION
STESD and POEM are effective and safe for the treatment of dysphagia caused by mid-esophageal diverticula with diffuse esophageal spasm.
Core Tip: A rare case of mid-esophageal diverticulum with diffuse esophageal spasm is described. The case highlights the importance of considering diffuse esophageal spasm when treating mid-esophageal diverticulum. Diagnostic tools such as upper gastrointestinal pan-glucosamine contrast, esophageal manometry, chest computed tomography, and gastroscopy can be helpful. Submucosal tunneling endoscopic septum division + per-oral endoscopic myotomy is an effective treatment approach for this condition.
