PMC10318124_01
Endoscopic appearance of the esophagus. (a) Endoscope insertion: Severe stenosis due to extramural compression of the posterior wall is identified in the middle thoracic esophagus. (b) Endoscope removal: A laceration is observed at the stenosis.
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Tokyo, Japan) was performed for screening prior to EUS evaluation, revealing a narrowing of the lumen due to compression of the posterior wall in the middle thoracic esophagus (Figure 1a). The endoscope passed through the stenosis with resistance, and a laceration was observed at the site during removal (Figure 1b). Thus, we decided against performing EUS owing to the risk of esophageal perforation due to the use of a large side-view endoscope. Because the symptoms were resolved by day 2, the patient was monitored without additional treatment; he resumed eating on day 10 and was discharged on day 17 (Figure S1).
Computed tomography (CT) image on admission (a) Volume-rendered, reconstructed sagittal section of the contrast-enhanced CT image: The esophagus (red arrow) is constricted due to extrinsic compression from an osteophyte (red arrowhead) on the sixth thoracic vertebra, and the anterior esophageal surface is restricted by the left pulmonary artery (*). (b) Axial section of the contrast-enhanced CT image: The esophagus has migrated to the left side of the trachea due to compression from the vertebral osteophyte (black arrow). The migration of its anterior surface is restricted by the left pulmonary artery (*). (c) Sagittal section of a plain CT image obtained at another hospital 8 years ago: The vertebral osteophyte (red arrowhead) appears smaller in size. (d) Axial section of the plain CT image obtained from another hospital 8 years ago: The vertebral osteophyte (black arrow) appears smaller in size.
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The left pulmonary artery restricted the anterior esophageal surface (Figure 2a). Axial CT revealed that the esophagus had migrated to the left side of the trachea due to compression from the vertebral osteophyte (Figure 2b). The degree of osteophyte formation had intensified following a plain CT performed at another hospital 8 years ago (Figure 2c,d).