title: Endoscopic management of esophageal discontinuity.
abstract: BACKGROUND
  The management of esophageal discontinuity remains challenging and often involves complex reconstructive surgeries.
  
  
  RESULTS
  We describe a unique and successful treatment of esophageal discontinuity using a modification of the natural orifice translumenal surgery (NOTES) approach in a patient presenting with long-standing esophageal discontinuity resulting from an iatrogenic esophageal injury.
  
  
  CONCLUSIONS
  This case provided an opportunity to affirm the efficacy of endoscopy for treating esophageal discontinuities to minimize the degree of morbidity and mortality normally associated with the surgical treatment of this type of injury. Our case reveals a novel and possibly more direct means of evaluating and treating esophageal injuries in which the degree of discontinuity and/or stenosis initially remains unknown.
authors.affiliation: Department of Otolaryngology, Tripler Army Medical Center, Honolulu, Hawaii.
authors.forename: Edward T
authors.initials: ET
authors.lastname: Chang
authors.affiliation: Department of Otolaryngology, Tripler Army Medical Center, Honolulu, Hawaii.
authors.forename: Douglas S
authors.initials: DS
authors.lastname: Ruhl
authors.affiliation: Department of Gastroenterology, Tripler Army Medical Center, Honolulu, Hawaii.
authors.forename: Patrick R
authors.initials: PR
authors.lastname: Kenny
authors.affiliation: Department of Otolaryngology, Tripler Army Medical Center, Honolulu, Hawaii.
authors.forename: Joseph C
authors.initials: JC
authors.lastname: Sniezek
mesh_terms: D000328:Adult; D016145:Endoscopy, Digestive System; D004940:Esophageal Stenosis / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D004945:Esophagoscopy / Q000379:methods*; D004947:Esophagus / Q000293:injuries* / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007049:Iatrogenic Disease; D007431:Intraoperative Complications / Q000175:diagnosis / Q000601:surgery*; D057605:Natural Orifice Endoscopic Surgery / Q000379:methods*; D020127:Recovery of Function; D018570:Risk Assessment; D012720:Severity of Illness Index; D013965:Thyroidectomy / Q000009:adverse effects / Q000379:methods; D016896:Treatment Outcome
keywords: endoscopic transillumination; esophageal transection; esophagogastroduodenoscopy; esophagoscopy; panendoscopy