Abstract
A 15-year-old male patient presented with dysphagia, regurgitation, weight loss and retrosternal pain. The diagnosis of achalasia was made 4 years before. The esophagogram revealed severe esophagus dilatation and the classic “bird-beak” termination. A Heller myotomy plus fundoplication and endoscopic balloon dilatation were conducted four months previously. Nevertheless, the symptoms persisted and the last high-resolution manometry study still showed achalasia type II. The patient underwent a peroral endoscopic esophageal myotomy (POEM). POEM is a feasible and safe procedure for experienced and properly- equipped health care delivery centers and could be used as a rescue treatment in refr e present the youngest patient with achalasia in our region who had a successful response to rescue POEM.
Highlights
Achalasia is an uncommon primary motility disorder of the esophagus, characterized by loss of esophageal peristalsis and incomplete relaxation of the lower esophageal sphincter in response to swallowing [1]
We present the youngest patient with achalasia in our region who had a successful response to rescue peroral endoscopic esophageal myotomy (POEM)
The diagnosis of achalasia in our patient was made at 11 years old, when he was considered part of the pediatric population; the disease in children is very rare, with a reported incidence of 0.1-0.18/100,000 persons per year [3]
Summary
Peroral endoscopic myotomy in a pediatric patient with refractory achalasia: a case report and review of the literature. Miotomía endoscópica vía oral en un paciente pediátrico con acalasia refractaria: reporte de caso y revisión de la literatura. Gonzales-Carazas, Luis Marin Calderón, Jorge Vásquez Quiroga, Edgar Alva Alva, Paulo Bardalez Cruz, Fernando Palacios Salas. Recibido: 23/6/20 - Aprobado: 01/03/21 ORCID: Lesly Calixto-Aguilar: http://orcid.org/0000-0001-9202-0831, Evelyn F. Gonzales-Carazas: https://orcid.org/0000-0002-8405-7439, Luis Marin Calderón: https://orcid.org/0000-0002-3407-1902, Jorge Vásquez Quiroga: https://orcid.org/0000-0003-1451-4590, Edgar Alva Alva: https://orcid.org/0000-0003-1259-0522, Paulo Bardalez Cruz: https://orcid.org/0000-0001-6910-7090, Fernando Palacios Salas: https://orcid.org/0000-0003-2229-2238
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