title: Transoral closure of pharyngeal perforation caused by gastrointestinal endoscopy.
abstract: OBJECTIVE
  We present a case of pharyngeal perforation caused by gastrointestinal endoscopy that was successfully repaired with transoral mucosal sutures. This is the first report of a transoral surgical closure of a perforation caused by an endoscope. We describe the repair procedure, the necessary equipment, and the effectiveness of suturing pharyngeal perforations.
  
  
  METHODS
  An 87-year-old woman brought to our emergency department by ambulance because of hematemesis and endoscopic hemostasis was successfully performed. But after hemostasis, CT scan showed emphysema extending from the right lower jaw to the superior mediastinum and pharyngeal perforation was observed by laryngeal fiberscope.
  
  
  METHODS
  Even though she had received conservative treatment, exacerbation of inflammation was observed and therefore we performed transoral surgery for closing the pharyngeal perforation.
  
  
  METHODS
  We followed up with CT scans, blood test and vital signs.
  
  
  RESULTS
  The pharyngeal perforation smoothly closed and exacerbation of inflammation was not observed, even after oral ingestion began.
  
  
  CONCLUSIONS
  Transoral closure of a pharyngeal perforation is less invasive and performing this procedure at an early stage can lead to a favorable outcome.
authors.affiliation: Department of Otolaryngology, Head, and Neck Surgery Japanese Red Cross Shizuoka Hospital, Shizuoka, Japan; Department of Otolaryngology, Head and Neck Surgery, Keio University School of Medicine, Tokyo, Japan. Electronic address: wasano@a5.keio.jp.
authors.forename: Koichiro
authors.initials: K
authors.lastname: Wasano
authors.affiliation: Department of Otolaryngology, Head, and Neck Surgery Japanese Red Cross Shizuoka Hospital, Shizuoka, Japan.
authors.forename: Sayuri
authors.initials: S
authors.lastname: Hashiguchi
authors.affiliation: Department of Otolaryngology, Head, and Neck Surgery Japanese Red Cross Shizuoka Hospital, Shizuoka, Japan.
authors.forename: Noriomi
authors.initials: N
authors.lastname: Suzuki
authors.affiliation: Department of Otolaryngology, Head, and Neck Surgery Japanese Red Cross Shizuoka Hospital, Shizuoka, Japan.
authors.forename: Taiji
authors.initials: T
authors.lastname: Kawasaki
authors.affiliation: Department of Otolaryngology, Head, and Neck Surgery Japanese Red Cross Shizuoka Hospital, Shizuoka, Japan.
authors.forename: Ichirota
authors.initials: I
authors.lastname: Nameki
authors.affiliation: Department of Otolaryngology, Head, and Neck Surgery Japanese Red Cross Shizuoka Hospital, Shizuoka, Japan.
authors.forename: Hideo
authors.initials: H
authors.lastname: Nameki
mesh_terms: D000369:Aged, 80 and over; D016145:Endoscopy, Digestive System / Q000009:adverse effects*; D005260:Female; D006801:Humans; D007828:Laryngoscopy; D010608:Pharyngeal Diseases / Q000209:etiology / Q000601:surgery*; D010614:Pharynx / Q000293:injuries* / Q000601:surgery; D011859:Radiography; D013352:Subcutaneous Emphysema / Q000000981:diagnostic imaging* / Q000209:etiology; D013536:Suture Techniques
keywords: Pharyngeal perforation; Transoral surgey; Weerda distending laryngoscope