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. 2013;4(4):396-8.
doi: 10.1016/j.ijscr.2013.01.014. Epub 2013 Jan 28.

Laparoscopic Heller's myotomy for achalasia after gastric bypass: A case report

Rhiannon Chapman  1 , Adrianna Rotundo, Nick Carter, Jason George, Andrew Jenkinson, Marco Adamo
Affiliations

Laparoscopic Heller's myotomy for achalasia after gastric bypass: A case report

Rhiannon Chapman et al. Int J Surg Case Rep. 2013.

Abstract

Introduction: Disorders of the oesophagus have been linked to surgical bariatric procedures and obesity. However the relationship between achalasia and gastric bypass is not clearly understood and has only recently been reported following gastric bypass.

Presentation of case: We present the case of a 53-year-old woman who re-presented following a gastric bypass with a new diagnosis of achalasia. This was treated successfully with laparoscopic Heller's Myotomy with discharge from hospital 10 days post operatively.

Discussion: It is not clear whether achalasia is a complication of gastric bypass procedures. This is only the second reported case of the condition developing after this operation. The mechanism by which it may develop is yet to be clearly established.

Conclusion: This case highlights the need to investigate further a possible link between achalasia and gastric bypass and to manage susceptible patients accordingly in the pre-operative stage.

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Figures

Fig. 1
Fig. 1
Gastrografin swallow test prior to a Heller's myotomy. The thoracic oesophagus is grossly dilated and the lower oesophageal sphincter narrowed.
Fig. 2
Fig. 2
High-resolution oesophageal manometry (HRM) illustrating oesophageal aperistalsis, absence of lower oesophageal sphincter relaxation and grossly decreased impedance activity.
See this image and copyright information in PMC

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