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Peroral endoscopic myotomy in achalasia and large epiphrenic diverticulum
Author(s) -
Demeter Michal,
Bánovčin Peter,
Ďuriček Martin,
Kunda Rastislav,
Hyrdel Rudolf
Publication year - 2018
Publication title -
digestive endoscopy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.5
H-Index - 56
eISSN - 1443-1661
pISSN - 0915-5635
DOI - 10.1111/den.12961
Subject(s) - medicine , achalasia , myotomy , dysphagia , regurgitation (circulation) , surgery , diverticulum (mollusc) , esophagus
Symptomatic epiphrenic diverticula are mostly treated surgically with laparoscopic diverticulectomy, myotomy and anterior fundoplication. However, in case the patient does not agree with surgical therapy or is contraindicated, there are limited ways of alternative treatment. We present a case report of a 72‐year‐old female patient with severe dysphagia, regurgitation, paroxysmal cough, weight loss and malnutrition who was diagnosed with achalasia and large epiphrenic diverticulum. She did not give consent to the proposed surgical treatment. Alternatively, peroral endoscopic myotomy (POEM) was carried out. In one‐year follow up, we observed complete symptom resolution, significant weight gain, improvement of nutritional status and no complications. We suggest that POEM could serve as an effective and safe alternative treatment for patients with achalasia and esophageal epiphrenic diverticula.