BACKGROUND
Achalasia is a primary esophageal motility disease characterized by impairment of normal esophageal peristalsis and absence of relaxation of the lower esophageal sphincter. Sometimes is can be a part of some genetic disorders. One of the causes of gastrointestinal motility disorders, including achalasia, is mitochondrial defects.
CASE SUMMARY
We report about a pregnant woman with a history of symptoms associated with inherited mitochondrial disease, which was confirmed by genetic tests, and who was treated
via
peroral endoscopic myotomy.
CONCLUSION
Peroral endoscopic myotomy is possible treatment option for a pregnant woman with achalasia caused by mitochondrial disease.
To treat the patient with Achalasia and prevent the symptoms of gastroesophageal reflux the Peroral Endoscopic Myotomy with Simultaneous Endoscopic Fundoplication was done by the current authors. After performing a myotomy the endoloop was fixated to the stomach and was attached to the muscle of the esophagus by using the endoclips. The endoloop was tightened therefore shaping the cuff. This operation has been technically feasible and no immediate or delayed complications occurred.
A Peroral Endoscopic Myotomy was performed on the patient with the persistent dysphagia despite preceding Heller myotomy combined with partial fundoplication, relaparotomy, fundoplication wrap reconstruction, gastrostomy and left-sided thoracoscopy with the drainage of the thoracic abscess. The use of intraoperative High-Resolution Manometry during Endoscopic Peroral Myotomy helped to reveal the reasons for the failure of previous treatment and to address the dysphagia.
The objectiveof the study is to evaluate the safety and efficacy of the using of minimally invasive endoscopic methods in the treatment of submucosal esophageal tumors.Material and methods.The study included 89 patients with benign tumors of the esophagus. Endoscopic ultrasonography (EUS) was performed to determine the esophageal wall layer from which the tumor grows the size of the tumor and its relationship with the surrounding organs.Results.Submucosal tunneling resection was performed successfully in 73 patients. The average operation time was 84.5 minutes. In 16 patients, the tumor was removed by submucosal endoscopic dissection (SED). The average duration of ESD was 39.4 minutes. Among this group of patients we faced nonstandard cases of practical interest: leiomyomas of the upper part of the esophagus, plexiform leiomyomas and multiple leiomyomas. Each of the above types had its own specificity in diagnosis, treatment and postoperative management of patients.Conclusion.Submucosal esophageal tumors vary in types of growth, sizes, number of tumors, localization and its relationship with the surrounding organs. Scrupulous diagnosis of each case is necessary which will allow choosing the most appropriate treatment tactics for the patient.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.