RESUMO
We present a case report of peroral endoscopic myotomy (POEM) in the treatment of pediatric patient with achalasia and annular stenosis in lower esophagus. A 9-year-old girl was newly diagnosed with achalasia. After assessment, the patient underwent POEM procedure and the retrievable stent was implanted in the esophagus. Postoperatively, lung CT suggested esophagopleural fistula, while gastroscopy showed that the metal stent was displaced to the esophageal lumen. A fistula was found in the lower esophageal segment after the stent was removed. Emergency operation of endoscopic perforation repair and esophageal stent replacement were performed. The patient recovered well in the next 6 months of follow-up. (AU)
Assuntos
Humanos , Feminino , Criança , Acalasia Esofágica , Miotomia , Transtornos da Motilidade Esofágica , EsôfagoRESUMO
Introduction: per-oral endoscopic myotomy (POEM) hasbecome a mainstream treatment for achalasia and is apromising therapy in spastic disorders.Methods: this is a retrospective study of prospectively collected data (case series). We present the first results of theuse of POEM in patients with atypical spastic esophagealmotor disorders that do not satisfy current Chicago Classification criteria. Seven consecutive patients with troublesome and persistent symptoms (12-180 months) relatedto atypical spastic esophageal motor dysfunction weresystematically assessed before and after POEM, the extentof which was tailored by manometric findings. In five ofthe patients, other endoscopic or surgical procedures hadfailed.Results: high-resolution manometry (HRM) showed a spasticesophageal body contractile segment in varying positionsand lengths along the esophageal body which did not meet Chicago Classification criteria. After POEM, dysphagia and/or chest pain had either resolved or was greatly reduced.HRM 3-6 months after myotomy showed that the regions ofspastic contraction targeted by myotomy had been ablated.There were no major complications. The clinical responseswere fully maintained up to the most recent assessmentsafter POEM (range 7-44 months).Conclussion: in our seven patients, POEM was a highly effective treatment for patients with troublesome symptoms related to atypical spastic esophageal motility disorders. (AU)
Assuntos
Humanos , Acalasia Esofágica/diagnóstico , Transtornos da Motilidade Esofágica , Esofagoscopia/métodos , Manometria/métodos , Espasticidade Muscular/etiologia , Miotomia/métodos , Resultado do Tratamento , Estudos RetrospectivosRESUMO
No disponible
Assuntos
Humanos , Masculino , Pessoa de Meia-Idade , Miotomia/métodos , Ressecção Endoscópica de Mucosa/métodos , Acalasia Esofágica/cirurgia , Esofagoscopia/métodos , Cirurgia Endoscópica por Orifício Natural/métodos , Leiomioma/diagnóstico por imagem , Acalasia Esofágica/diagnóstico por imagem , Leiomioma/cirurgiaRESUMO
No disponible
