case_images: PMC10042631_01
case_images: Large ulcerating mass in the middle third of the esophagus, 26 cm from the incisors on the UGIE.
case_images: CRIGM2023-9437558.001.jpg
case_images: PMC10042631_01_CRIGM2023-9437558.001.jpg
case_images: fig1
case_images: The patient was found to have a large ulcerating mass with stigmata of recent bleeding on the middle third of the esophagus, 26 cm from the incisors (Figure 1).
case_images: Capnography showing an abrupt end-tidal CO2 rise to 99 mmHg with full insufflation of the esophagus with carbon dioxide (CO2), suggesting the presence of TEF.
case_images: CRIGM2023-9437558.002.jpg
case_images: PMC10042631_01_CRIGM2023-9437558.002.jpg
case_images: fig2
case_images: During the procedure, minimal CO2 was used for insufflation, but when attempts were made to traverse the obstruction, capnography revealed an end-tidal CO2 (EtCO2) estimating 90 mmHg indicating a high likelihood of TEF (Figure 2 showing the pattern of end-tidal CO2 on capnography during endoscopy).