Overview
The esophageal achalasia is a primary motor disorder characterized by an abnormal motility of the upper part of the esophagus and also by a lack of easing on the lower esophageal sphincter as a response to the swallowing.
Case presentation: Male of 1 year and 6 months of age with severe malnutrition. Body mass index (BMI) of 1.4 with late of the psychomotor development, with vague symptoms of esophageal reflux; weight at revenue of 5 kg, double contrast upper-GI series for study of Gastroesophageal Reflux Disease (GERD), with presence of esophageal expansion in third distal.
We proceed with the placement of a trocar of 5 mm in umbilical scar, one of 5 mm to subxifoid level for hepatic separation and two more of 5 mm to level of flanks as ports of work. There is proceeded to fulfil the miotomy of the region of the sphincter approximately 3 cm of the intra-abdominal esophagus, the funduplication realizes type Thal and procedure concludes.
Discussion:The best treatment is the surgery. The laparoscopic boarding must be used of routine because it allows an easy access to the low third of the esophagus, it allows to realize some anti reflux procedure, avoids the need to install a pleurostomy, diminishes the postoperatory pain and the complications of respiratory type that could be produced, favors the early discharge and therefore a rapid reintegration to the life habitual.
The Heller Myotomy Procedure
Your surgeon will discuss with you whether you are a candidate for an esophageal (Heller) myotomy. UW Health surgeons divide the non-relaxing muscle at the end of your esophagus and at the beginning of your stomach.
They may also wrap part of your stomach around your esophagus so that you do not develop gastroesophageal reflux disease from your esophageal myotomy. This procedure is called fundoplication.
Symptoms
The following achalasia symptoms may suggest the necessity for surgical intervention:
- Swallowing problems
- Frequent regurgitation or lung problems related to regurgitation
- Weight loss
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