Transoral endoscopic stapled diverticulotomy for pediatric esophageal diverticulum: a case report

Introduction Pharyngoesophageal diverticula are rare in the pediatric population and are typically managed with open surgical approaches. Minimally invasive surgical (MIS) approaches are well established in adults however, to date, no MIS technique for pediatric esophageal diverticula has been described in the literature. Case presentation A 12-year-old female presented with neck and chest pain, dysphagia, and difficulty breathing and speaking following ingestion of food from a broken glass jar. Imaging demonstrated a retropharyngeal abscess with a retained foreign body requiring thoracoscopic drainage. The patient subsequently developed a cervical esophageal diverticulum associated with persistent symptoms. She underwent transoral endoscopic stapled diverticulotomy using a 5 mm linear stapler in collaboration with otolaryngology. Postoperatively, symptoms resolved, and follow-up imaging confirmed complete resolution. At nine-year follow-up, the patient remains asymptomatic without recurrence. Conclusion Transoral endoscopic stapled diverticulotomy using a 5 mm stapler is a feasible and effective minimally invasive option to treat pediatric pharyngoesophageal diverticula, offering a potential alternative to traditional open repair in select cases.