Danielle T Friedman, MD, Ajay K Chopra, MD. Jacobi Medical Center
Achalasia is not commonly associated with either morbid obesity or young patients. Conclusive evidence is scarce and management is controversial. Options include sequential or simultaneous Heller myotomy or per-oral endoscopic myotomy with sleeve gastrectomy or gastric bypass; achalasia is a contraindication to gastric banding due to exacerbation of dyspagia. We present a thirty year old woman with morbid obesity (BMI 42) diagnosed with achalasia after she reported dysphagia to liquids and solids during her bariatric preoperative evaluation. Manometry and barium esophagogram findings consistent with type I achalasia are presented. Although she was interested in sleeve gastrectomy, given her achalasia and the risk for reflux after myotomy decision was made to pursue combined laparoscopic Heller myotomy and roux-en-Y gastric bypass. At four months postoperatively she has lost forty pounds, is tolerating solid diet, and has no symptoms of either dysphagia or gastroesophageal reflux.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 80752
Program Number: V168
Presentation Session: Foregut 3
Presentation Type: Video