Recently, endoscopic submucosal dissection (ESD) has been applied for the removal of superficial esophageal neoplasms [1]. Here, we report on the endoscopic management of a perforation during esophageal ESD, which resulted from an unexpected partial muscular defect. An 80-year-old man underwent gastrointestinal endoscopy, and a lesion was detected on the left side of the middle thoracic esophag...