A Rare Pharynx Malformation.

A 77-year-old man was admitted for abdominal pain. He had no anemia or abnormal physical findings. We diagnosed the patient with chololithic pancreatitis, and performed endoscopic retrograde cholangiopancreatography.

We began to insert a side-viewing duodenoscope, but had difficulty passing it through the left pyriform sinus. When we switched to a forward-viewing duodenoscope, we found that membrane-like structures on the left and right sides were restricting part of the circular posterior area of the entrance to the esophagus, and that the left and right pyriform sinuses were closed (Picture 1, 2). We switched back to the side-viewing duodenoscope were able to insert it by carefully passing it through the entrance of the esophagus.

Picture 1.

Picture 2.

Perforation and other procedural accidents can occur during gastrointestinal endoscopy because the endoscopist often blindly passes it through the pyriform sinus (1,2). This type of anomaly has never been reported, we believe it is important for endoscopists to take care in similar cases.