The defect.
A patient presented acutely with chest pain following an outside procedure, with imaging confirming a mid-esophageal full-thickness defect of approximately 12 mm. Surgical management would have meant a thoracotomy, prolonged NPO status, and an extended hospital stay.
The closure.
An over-the-scope clip was deployed in a single endoscopic session, achieving full-thickness apposition of the defect edges. A water-soluble contrast study at 48 hours confirmed no extravasation. The patient resumed soft oral intake on day three and was discharged on day four.
Why this case is here
Because the OTSC system has, in the right hands and the right setting, moved a substantial number of acute esophageal perforations out of the operating theatre and into the endoscopy suite. The local availability of that capability matters.