PMC9876012_01
The esophageal septum/stenosis.
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F1
There was no pinhole, and the scope could not pass (Figure 1).
Transillumination seen by the ultraslim scope from below.
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F2
The transillumination from the adult EGD was seen by the ultraslim scope on the opposite side (Figure 2).
Needle knife septotomy.
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F3
Free needle septotomy was performed under the guidance of both the transillumination and under direct visualization (Figure 3).
Savary guidewire advancement through the septotomy under the direct vision of the adult scope.
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F4
A Savary wire was advanced under the direct vision of the adult gastroscope through the septotomy, and the adult gastroscope was removed (Figure 4).
Esophageal dilation using the savary dilator.
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F5
Dilation was performed with a Savary dilator with no resistance at 5, 7, and 9 mm under fluoroscopy and endoscopy guidance with the ultraslim scope situated in the distal esophagus (Figure 5).
Repeat EGD showing a patent esophagus.
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F6
EGD was repeated 2 weeks later and showed partial stricture with normal mucosa, which was traversed with the ultraslim gastroscope, and a repeat dilation using a through-the-scope 9 mm balloon was performed (Figure 6).