Department of Gastroenterology, Hospital Nacional Edgardo Rebagliati Martins. Lima, Peru.
Department of Gastroenterology, Hospital Nacional Edgardo Rebagliati Martins. Lima, Peru; Clínica Internacional. Lima, Peru.
Rev Gastroenterol Peru. 2021 Jan-Mar;41(1):37-40.
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 refractory achalasia. We present the youngest patient with achalasia in our region who had a successful response to rescue POEM.
一位 15 岁男性患者以吞咽困难、反流、体重减轻和胸骨后疼痛为主诉就诊。4 年前被诊断为贲门失弛缓症。食管造影显示严重食管扩张和典型的“鸟嘴”末端。四个月前进行了 Heller 肌切开术加胃底折叠术和内镜球囊扩张术。然而，症状仍然存在，最近的高分辨率测压研究仍显示 II 型贲门失弛缓症。患者接受了经口内镜下食管肌切开术（POEM）。POEM 是一种可行且安全的手术，适用于有经验和设备齐全的医疗服务中心，并且可以作为难治性贲门失弛缓症的抢救治疗方法。我们报告了本地区最年轻的贲门失弛缓症患者，他对抢救性 POEM 有良好的反应。
