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The diagnosis relies on bone marrow examination and immunosuppressive therapy is effective. For AP with skin changes, the possibility of HPS should be considered during clinical work.Background Fistulization is a rare complication of esophageal diverticula. Patients with this condition often require surgery, which unfortunately can be invasive and traumatic. Endoscopic therapy is an alternative method for treating esophageal fistula. Hereby we introduce a new endoscopic technique that uses an esophageal pedicle flap to close esophageal fistulas. Cas