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Esophageal retention cyst: Esophagogastric junction outflow obstruction (EGJOO) as a potential etiology and management with endoscopic mucosal resection (EMR)
Journal article   Open access   Peer reviewed

Esophageal retention cyst: Esophagogastric junction outflow obstruction (EGJOO) as a potential etiology and management with endoscopic mucosal resection (EMR)

Nisarg Mehta, Shahin Ayazi, Michael Landau, Sven Eriksson and Blair A. Jobe
International journal of surgery case reports, v 95, 107194
01 Jun 2022
DOI: https://doi.org/10.1016/j.ijscr.2022.107194
PMID: 35569311
Featured in Collection :   UN Sustainable Development Goals @ Drexel
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https://doi.org/10.1016/j.ijscr.2022.107194View
Published, Version of Record (VoR)CC BY V4.0,  Open

Abstract

Life Sciences & Biomedicine Science & Technology Surgery
Introduction and importance: Esophageal retention cysts are acquired cysts with no known etiology. They are characterized by dilation of the submucosal glands. Symptomatic cysts are traditionally managed by surgical resection. Case presentation: We present a case of progressive dysphagia and chest pain secondary to esophageal retention cysts in the mid and distal esophagus with associated esophagogastric junction outflow obstruction (EGJOO) and jackhammer esophagus on high resolution manometry (HRM). The patient underwent staged endoscopic mucosal resection (EMR) with subsequent improvement in her symptoms. However, EGJOO persisted after resection, suggesting it was the primary pathology and not a consequence of the obstruction from the cysts. Clinical discussion: Esophageal retention cysts are rarely reported in the literature with most descriptions coming from incidental post-mortems. The presented case suggests EGJOO as a potential etiology of retention cysts. The proposed mechanism is that a significant rise in esophageal intraluminal pressure creates a state of stasis in the esophagus, ideal for the development of these cysts. Symptomatic or malignant retention cysts should be resected. We demonstrate the feasibility of EMR as an alternative to surgical resection. Conclusion: Esophageal retention cyst is a rare entity, which may arise as a result of EGJOO. The natural history and malignant potential of these cysts are unknown, and no formal guidelines have been established for followup for patients with asymptomatic retention cysts. Endoscopic mucosal resection can be used to successfully manage these cysts.

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Collaboration types
Domestic collaboration
Web of Science research areas
Surgery
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