Clin Endosc.  2020 May;53(3):370-373. 10.5946/ce.2019.109.

Submucosal Tunneling Muscle Biopsy for Esophageal Motility Disorders: A Case Report

• Smirnov AA
• Kiriltseva MM
• Burakov AN
• Maksimov MV
• Botina AV
• Saadulaeva MM
• Konkina NV

• KMID: 2502774
• DOI: http://doi.org/10.5946/ce.2019.109

Abstract

Submucosal tunneling endoscopic technique can be useful in obtaining esophageal muscle specimens in patients with esophageal motility disorders. Here, we describe the case of a patient with systemic sclerosis. Histological verification of the esophageal involvement in the pathological process was required for the treatment. There were no intra- and post- operational complications.

Keyword

Esophagus; Motility disorders; Systemic sclerosis; Tunneling biopsy

Figure

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  Fig. 1. High-resolution esophageal manometry. (A) Wet swallow (5 mL): no esophageal contractions. (B) Multiple rapid swallow test: no esophageal contractions.

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  Fig. 2. Steps of the tunneling muscle biopsy. (A) Esophagogastric junction from the lower part of the esophagus. (B) Esophagogastric junction from the stomach. (C) Submucosal injection. (D) Submucosal tunnel. (E) Place of the resected specimen. (F) Resected specimen.

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  Fig. 3. (A) Atrophy and sclerosis of the circular muscular layer (hematoxylin and eosin, ×200). (В) Atrophy and sclerosis of the longitudinal muscular layer (hematoxylin and eosin, ×40). CML, circular muscular layer; LML, longitudinal muscle layer.

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  Fig. 4. (A) Perivascular sclerosis; (B) perineural sclerosis (Van Gieson’s stain, ×200).

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  Fig. 5. Inflammatory infiltration composed predominantly of lymphocytes of the myenteric plexus. (А) Thickening of the vessel wall; (В) proliferative endarteritis with obliteration of the lumen of blood vessel (hematoxylin and eosin, ×200).

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