Division of Gastroenterology, Henry Ford Hospital, Detroit, MI 48202, United States.
Department of Internal Medicine, University of Missouri-Kansas City, Kansas City, MO 64108, United States.
World J Gastroenterol. 2017 Oct 7;23(37):6902-6906. doi: 10.3748/wjg.v23.i37.6902.
Achalasia is a rare esophageal motility disorder that is characterized by a loss of peristalsis in the distal esophagus and failure of lower esophageal sphincter relaxation. The risk of developing esophageal motility disorders, including achalasia, following bariatric surgery is controversial and differs based on the type of surgery. Most of the reported cases occurred with laparoscopic adjustable gastric banding. To our knowledge, there are only three reported cases of achalasia after Roux-en-Y gastric bypass and no reported cases after revision of the surgery. We present a case of a 70-year-old female who had a previous history of Roux-en-Y gastric bypass with revision. She presented with persistent nausea and regurgitation for one month. Esophagogastroduodenoscopy showed a dilated esophagus without strictures or stenosis. A barium study was performed after the endoscopy and was suggestive of achalasia. Those findings were confirmed by a manometry. The patient was referred for laparoscopic Heller's myotomy.
贲门失弛缓症是一种罕见的食管动力障碍，其特征为食管远端蠕动丧失和下食管括约肌松弛失败。减重手术后发生食管动力障碍（包括贲门失弛缓症）的风险存在争议，并且因手术类型而异。大多数报道的病例发生在腹腔镜可调节胃束带术之后。据我们所知，只有三例报道的胃旁路手术后发生贲门失弛缓症，而没有报道的手术后修正手术的病例。我们报告了一例 70 岁女性，曾行胃旁路术后修正术，现出现持续性恶心和呕吐 1 个月。食管胃十二指肠镜检查显示食管扩张，无狭窄或梗阻。内镜检查后行钡餐检查，提示贲门失弛缓症。这些发现通过测压法得到证实。患者被转介行腹腔镜 Heller 肌切开术。
