Early Esophageal Wall Abscess After Submucosal Tunneling Endoscopic Resection of an Esophageal Leiomyoma Successfully Managed by Clip Removal and Targeted Antibiotic Therapy

A 24-year-old man with progressive dysphagia underwent submucosal tunneling endoscopic resection for a mid-esophageal leiomyoma. Within 24 hours, he developed chest pain, fever, tachycardia, and subcutaneous emphysema. CT showed bilateral pneumothorax and a periesophageal collection, and endoscopy revealed purulent discharge from the closure site. Clip removal allowed drainage, broad-spectrum antibiotics were started, and a nasojejunal tube was placed. He recovered fully with resolution of the pneumothorax, emphysema, and abscess. Follow-up endoscopy showed healed pseudodiverticula. This case highlights a rare early postsubmucosal tunneling endoscopic resection esophageal wall abscess and the value of timely recognition and endoscopic management.