Achalasia cardia is the rare chronic neurodegenerative disorder of the esophagus which causes progressive delay in contractility of lower esophageal muscles during swallowing leading to backup of food contents and fluids in later stages within the region of esophagus. It is considered as the common leading cause of motor dysphagia. The underlying etiology include autoimmune disorder, nervous degeneration due to loss of inhibitory ganglion in myenteric plexus of esophagus, presence of inhibitory neurotransmitters such as nitric oxide and its receptors in lower esophagus. At initial presentation drugs are prescribed as the symptoms mimic other GI disorders which often lead to delayed diagnosis. The symptoms mainly include severe pain or discomfort of chest after eating, weight loss, regurgitation of bland undigested food or saliva, severe heartburn, dysphagia, aspiration. Initial treatment includes the pharmacotherapeutic management to alleviate the symptoms and improve the esophageal outflow. Surgical treatment involves pneumatic dilatation, Heller’s myotomy, preoral endoscopic myotomy, esophagectomy. Heller’s myotomy may be performed by open or laparoscopic procedure. It is done along with Dor’s fundoplication. Case report discussed below is of a 55 years old female patient presented with dysphagia for one year. The symptoms of which worsened for 2 months along with vomiting of undigested foul-smelling food.
Iatrogenic Esophageal Perforation After Laparoscopic Heller’s Myotomy Treated Successfully with Endoscopic Stent: Case Report and Literature Review
