PMC10042631_01
Large ulcerating mass in the middle third of the esophagus, 26 cm from the incisors on the UGIE.
CRIGM2023-9437558.001.jpg
PMC10042631_01_CRIGM2023-9437558.001.jpg
fig1
The patient was found to have a large ulcerating mass with stigmata of recent bleeding on the middle third of the esophagus, 26 cm from the incisors (Figure 1).
Capnography showing an abrupt end-tidal CO2 rise to 99 mmHg with full insufflation of the esophagus with carbon dioxide (CO2), suggesting the presence of TEF.
CRIGM2023-9437558.002.jpg
PMC10042631_01_CRIGM2023-9437558.002.jpg
fig2
During the procedure, minimal CO2 was used for insufflation, but when attempts were made to traverse the obstruction, capnography revealed an end-tidal CO2 (EtCO2) estimating 90 mmHg indicating a high likelihood of TEF (Figure 2 showing the pattern of end-tidal CO2 on capnography during endoscopy).