Abstract

CALIXTO-AGUILAR, Lesly et al. Peroral endoscopic myotomy in a pediatric patient with refractory achalasia: a case report and review of the literature. Rev. gastroenterol. Perú [online]. 2021, vol.41, n.1, pp.37-40. ISSN 1022-5129.  http://dx.doi.org/10.47892/rgp.2021.411.1242.

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.

Keywords : Esophageal achalasia; Adolescent; Pyloromyotomy; Myotomy; Endoscopy.

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