Removal of press-through-packs impacted in the upper esophagus using an overtube

Figure 1 Endoscopic image showing a press-through-pack impacted in the upper esophageal wall.

Figure 2 Method for removal of a press-through-pack impacted in the upper esophagus. A: The press-through-pack was located using a diagnostic endoscope; B: an overtube was inserted and resulted in relaxation of the upper esophagus, which enabled the impacted press-through-pack to be moved; C: forceful pulling of the press-through-pack using forceps caused the edges of the PTP to bend, enabling it to enter the overtube.

Figure 3 Endoscopic image showing distal relocation of a press-through-pack that was previously impacted and immovable. Erosions proximal to the press-through-pack indicate the site at which the press-through-pack was impacted until insertion of the overtube.

Figure 4 A: Endoscopic image showing forceful retraction of the press-through-pack by a forceps; B shows how the edges of the press-through-pack were bent (arrow) during entry into the overtube.