Combined Anterograde and Retrograde Endoscopic Management of Complete Esophageal Obstruction in Absence of Fluoroscopic Guidance

Complete esophageal obstruction is a major side effect of radiotherapy for head and neck cancers. We present a 65-year-old man with complete esophageal obstruction due to chemoradiotherapy and 7 years of gastric tube dependence. A combined anterograde and retrograde endoscopic procedure was successfully performed using direct transillumination from the anterograde scope to visualize and excise the obstructing mucosa, without fluoroscopic guidance. The patient tolerated the procedure well, with no major complications on follow-up. This fluoroscopy-free rendezvous approach is a safe, effective option with practical applications, particularly in resource-limited settings.