Case Report
Complications involving the mediastinum after injection of Enteryx for GERD

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Case 1

A previously healthy 28-year-old Native American man presented for evaluation of GERD. Pathologic acid reflux was documented by ambulatory pH monitoring, and there was clinical improvement in response to treatment with a proton pump inhibitor (PPI). However, the patient wanted an alternative to pharmacotherapy. Thus, the patient underwent an EGD at which 5 injections (6.6 mL total) of Enteryx were made into the esophageal muscle layers within 1 cm of the gastroesophageal junction (GEJ) by using

Discussion

Both of our patients had mediastinal complications, after esophageal injection of Enteryx, for which hospitalization was required. The first patient was an appropriate candidate for the procedure, because pathologic reflux was documented, he responded to treatment with a PPI, and there was no obvious contraindication. Based on improvement in heartburn with PPI therapy, the second patient also met clinical criteria for Enteryx injection and had no contraindication, although she continued to have

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