摘要
BACKGROUND Bleeding from Zenker’s diverticulum is extremely rare.At present,there are no guidelines for the management of bleeding Zenker’s diverticulum because of its rarity.Per-oral endoscopic myotomy(Z-POEM)is a precision myotomy technique and minimally invasive procedure for the treatment of Zenker’s diverticulum.We present a systematic review and a rare case of bleeding Zenker’s diverticulum that was effectively treated using Z-POEM.CASE SUMMARY A 72-year-old presented after 3 d of hematemesis.He had a 2-year history of progressive dysphagia and reported no antiplatelet,anticoagulant,or nonsteroidal anti-inflammatory drug use.His vital signs were stable,and the hematocrit was 36%.Previous gastroscopy and barium swallow had revealed Zenker’s diverticulum before the bleeding occurred.We performed gastroscopy and found a 5-mm ulcer with a minimal blood clot and spontaneously resolved bleeding.Z-POEM for definitive treatment was performed to reduce accumulation of food and promote ulcer healing.He had no complications and no bleeding;at the follow-up 6 mo later,the ulcer was healed.CONCLUSION Z-POEM can be definitive prevention for bleeding ulcer in Zenker’s diverticulum that promotes ulcer healing,reducing the risk of recurrent bleeding.Z-POEM is also a definitive endoscopic surgery for treatment of Zenker’s diverticulum.
