INTRODUCTION: Achalasia is a pathology with an incidence of 1 in 100,000 inhabitants per year. There are very limited data on achalasia in the obese population, especially in those undergoing bariatric surgery. The approach of choice for cases of achalasia is fundoplication to correct the reflux; however, lacking a fundus due to a previous gastrectomy, an alternative that offers optimal results should be chosen. Here we present the surgical approach in a case of esophageal achalasia and a history of vertical sleeve gastrectomy, where we performed simultaneous Heller's cardiomyotomy and laparoscopic Roux-en-Y gastric bypass, as well as the results obtained. CASE PRESENTATION: 44-year-old woman with no chronic degenerative diseases, with a previous record of vertical sleeve gastrectomy 5 years ago, who started 1 year and 5 months earlier with dysphagia to liquids, then to solids, in addition to weight loss of 10 kilograms in 4 months. The BMI before vertical sleeve gastrectomy was 32 kg/m2, her BMI at the time of admission was 20 kg/m2; she also presented regurgitation and generalized weakness. After analyzing the surgical options, it was decided to perform a Heller cardiomyotomy and a Roux-en-Y gastric bypass. DISCUSSION AND CONCLUSIONS: The procedure turned out to be safe and successful in treating achalasia symptomatology, in addition to complete resolution of the reflux symptom.
Introduction: The ingestion of a foreign body (FB) is uncommon, yet important cause of gastrointestinal injury; it has more incidence in the pediatric population. Less than 1 % of the FB is associated with complications, particularly gastrointestinal perforations. We present the case of a 76 years old Case report: female, who refers lower quadrant abdominal pain of 48 hours of evolution, with gradually exacerbation over 1 day, The CT Findings reveal the presences of pneumoperitoneum and a high-density FB in the architecture of rectosigmoid colon, she underwent exploratory laparotomy with trans -surgical ndings: Perforation of 0.5 cm in rectosigmoid union, with the protrusion of a bone with perilesional edema. Treated with suturing in two planes, with good evolution. Most ingest Discussion and conclusions: ed FB pass through the GI tract uneventfully within 1 week, and is more common among children and older individuals. Patients with dentures, alcoholics and psychiatric patients are at high risk of FB ingestions. In the case of perforation due to foreign body, different techniques can be performed; the most common are: In the stomach, primary suture, in the small bowel, primary suture or segmental resection with anastomosis, and in the colon, sigmoid and rectum, primary suture, wound eversion by colostomy, segmental resection with anastomosis, and segmental resection with proximal colostomy.
Introduction: Achalasia is a pathology with an incidence of 1 in 100,000 inhabitants per year. There are very limited data on achalasia in the obese population, especially in those undergoing bariatric surgery. The approach of choice for cases of achalasia is the procedure partial fundoplication to correct the reflux; however, lacking a fundus due to a previous gastrectomy, an alternative that offers optimal results should be chosen. Here, we present the surgical approach in a case of esophageal achalasia and a history of vertical sleeve gastrectomy, where we performed a simultaneous Heller’s cardiomyotomy and laparoscopic Roux-en-Y gastric bypass, as well as the results obtained. Case Presentation: A 44-year-old woman with no chronic degenerative diseases, who had a vertical sleeve gastrectomy carried out 5 years ago. Her first symptoms manifested 17 months before, and they were dysphagia to liquids and then to solids, in addition to weight loss of 10 kg in 4 months. Her body mass index before the vertical sleeve gastrectomy was 32 kg/m2; her body mass index at the time of admission was 20 kg/m2; she also presented regurgitation and generalized weakness. After analyzing the surgical options, it was decided to perform a Heller cardiomyotomy and a Roux-en-Y gastric bypass. Discussion and Conclusions: The procedure turned out to be safe and successful in treating achalasia symptomatology, in addition to completely resolving the reflux symptoms.
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