POEM for Achalasia
- This 55 year old had significant trouble swallowing and chest pains due to achalasia.
- A complete clinical evaluation including Oeosophageal manometry confirmed the diagnosis. Findings on a contrast oesophageal suggestive exam suggestive of achalasia include a narrowed oesophago-gastric junction with a “bird-beak” appearance and oesophageal decreased motility (aperistalsis) or even oesophageal dilation. An oesophagoscopy may reveal a dilated oesophagus that contains residual material. The oesophageal mucosa usually appears normal.
- A per oral endoscopic myotomy (POEM) was performed.
- An incision into the lining of the oesophagus followed by the creation of a tunnel down to the sphincter between the oesophagus and the stomach.
- The oesophageal muscle and sphincter were subsequently divided.
- The patient had an excellent response at follow-up with resolution of their dysphagia and discomfort.
- POEM is a highly efficacious procedure in the management of achalasia, and represents a less invasive treatment option compared to traditional laparoscopic muscle division surgery (Laparoscopic Heller’s myotomy), with similar success and recurrence rates.