English (United Kingdom)

https://curated-unify.zendy.io/wp-json/zendy-region/v1/featured_content/oa?rat=en

https://curated-unify.zendy.io/wp-json/zendy-region/v1/highlighted_journal/

Global: Zendy Tools annual

Presents the keyphrase highlighting as premium feature

Keyphrase Highlighting

Presents the summarisation as premium feature

Summarisation

Insights

Presents the pdf analysis as premium feature

PDF Analysis

Presents the zaia usage as premium feature

ZAIA

Global: Zendy Tools monthly

Global: Zendy Plus monthly

Presents the access of premium content as premium feature

Premium Content

Global: Zendy Plus annual

Global: Zendy Free Plan

The Overstitch device has been used for closure of esophageal perforations [1]. A 40-year-old woman with type I achalasia underwent fluoroscopic pneumatic dilation in September 2015. Her mean lower esophageal sphincter (LES) pressure was 40mmHg. She had 100% esophageal aperistalsis and absence of LES relaxation. Endoscopy showed a tight but traversable esophagogastric junction (EGJ). A 30-mm achalasia balloon was used to perform dilation for 1 minute at 5 PSI followed by 1 minute at 8 PSI. She became pyrexial on the third day after dilation. Computed tomography (CT) showed a distal esophageal perforation with a small paraesophageal collection and left basal pleural effusion (●" Fig.1). Intravenous antibiotics were commenced and ultrasound-guided aspiration of the pleural fluid yielded 8mL of hemoserous fluid. An endoscopy on day 6 after dilation showed a 5-mm linear laceration above the EGJ (●" Fig.2a). It was repaired with two Overstitch polydioxanone (PDS) sutures using an Olympus 2T160 gastroscope (●" Fig.2b). Endoscopy and fluoroscopy 6 days after this repair showed that the repair was intact and the patient was discharged 13 days after the initial dilation. Gastroscopy at 4 weeks after repair showed good healing of the laceration with residual sutures at the repair site (●" Fig.2c). The patient’s LES pressure was 20.7mmHg; however, she was asymptomatic. At follow-up at 5 months, the patient complained of spasmodic epigastric pain without vomiting or dysphagia. A subseFig.1 Computed tomography (CT) scan showing a distal esophageal perforation with extraluminal gas locules abutting the posterior surface of the descending thoracic aorta at the level of the hiatus, along with a small paraesophageal collection and left basal pleural effusion.

Subacute food bolus obstruction secondary to a migrated Overstitch suture from a previous esophageal perforation repair