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

Calixto-Aguilar L.; Gonzales-Carazas E.F.; Marin Calderón L.; Vásquez Quiroga J.; Alva Alva E.; Bardalez Cruz P.; Palacios Salas F. · Revista de gastroenterologia del Peru : organo oficial de la Sociedad de Gastroenterologia del Peru (2021) · DOI: 10.47892/rgp.2021.411.1242

Resumen

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.