Peroral endoscopic myotomy in a pediatric patient with refractory achalasia: a case report and review of the literature

• Autores: Calixto-Aguilar, Lesly, Gonzales-Carazas, Evelyn F., Marin Calderón, Luis, Vásquez Quiroga, Jorge, Alva Alva, Edgar, Bardalez Cruz, Paulo, Palacios Salas, Fernando
• Formato: artículo
• Fecha de Publicación: 2021
• Institución: Sociedad de Gastroenterología del Perú
• Repositorio: Revista de Gastroenterología del Perú
• Lenguaje: español
• OAI Identifier: oai:ojs.revistagastroperu.com:article/1242
• Enlace del recurso: http://www.revistagastroperu.com/index.php/rgp/article/view/1242
• Nivel de acceso: acceso abierto
• Materia: Esophageal achalasia; Adolescent; Pyloromyotomy; Myotomy; Endoscopy

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 refr e present the youngest patient with achalasia in our region who had a successful response to rescue POEM.