A 70-year-old man underwent endoscopic submucosal dissection (ESD) for superficial esophageal cancer. Steroids were injected three times, including as an outpatient, to prevent stricture. On postoperative day 15, the patient presented to the outpatient clinic with chest pain and fever. Given the suspicion of mediastinitis, the patient was promptly admitted. Conservative treatment with antimicrobial agents was initiated, but the inflammatory response did not improve. On the eighth day of hospitalization, an ENBD tube was inserted into the post-ESD ulcer fistula using an upper gastrointestinal endoscope, and nasal mediastinal drainage was performed. The next day, the inflammatory response improved. The patient was discharged on day 31. We experienced a case in which mediastinitis was relieved by conservative treatment with endoscopic nasal mediastinal drainage.
