Endoscopy performed after passing a dilator and prior to passage of the next size dilator. A deep mucosal tear is evident in the mid esophagus (arrow). There were no clinical signs of immediate perforation. Esophagography (initially with Gastrografin®, a water-soluble contrast agent, and then with barium) was negative for a perforation.
Courtesy of Andres Gelrud, MD and Anthony Lembo, MD.
