Department of Surgery, College of Medicine, King Fahad Hospital of the University, Imam Abdulrahman bin Faisal University, Khobar, Saudi Arabia.
Department of Surgery, King Fahad Specialist Hospital, Dammam, Saudi Arabia.
Am J Case Rep. 2021 May 26;22:e931677. doi: 10.12659/AJCR.931677.
BACKGROUND Achalasia cardia is a neuro-degenerative motility disorder, which results in the loss of esophageal peristalsis along with failure of the lower sphincter to relax in response to swallowing. It is relatively rare, with a prevalence of 10 cases per 100 000 individuals. The criterion standard in the management of achalasia is laparoscopic Heller's myotomy with partial fundoplication. Esophageal perforation is one of the earliest major complications that could be managed by primary repair. However, it has been reported that esophageal perforations in achalasia cases can be managed with esophageal stenting after primary repair failure. CASE REPORT We are reporting a case of achalasia after Heller's myotomy in a 37-year-old man, which was complicated by iatrogenic esophageal perforation and was successfully managed by esophageal stenting after failed primary repair. CONCLUSIONS Esophageal stenting is a safe and effective management in cases of esophageal perforation after Heller's myotomy procedure.
贲门失弛缓症是一种神经退行性运动障碍，导致食管蠕动丧失，同时下食管括约肌在吞咽时无法放松。它相对较少见，每 100000 人中就有 10 例。贲门失弛缓症的治疗标准是腹腔镜下 Heller 肌切开术加部分胃底折叠术。食管穿孔是最早的主要并发症之一，可以通过一期修复来治疗。然而，据报道，在一期修复失败后，食管支架置入术可用于治疗贲门失弛缓症患者的食管穿孔。病例报告：我们报告了一例 37 岁男性在 Heller 肌切开术后发生的贲门失弛缓症，该患者发生医源性食管穿孔，在一期修复失败后通过食管支架置入术成功治疗。结论：食管支架置入术是治疗 Heller 肌切开术后食管穿孔的一种安全有效的方法。
