BACKGROUND Achalasia is a primary esophageal motility disease characterized by impairment of normal esophageal peristalsis and absence of relaxation of the lower esophageal sphincter. Sometimes is can be a part of some genetic disorders. One of the causes of gastrointestinal motility disorders, including achalasia, is mitochondrial defects. CASE SUMMARY We report about a pregnant woman with a history of symptoms associated with inherited mitochondrial disease, which was confirmed by genetic tests, and who was treated via peroral endoscopic myotomy. CONCLUSION Peroral endoscopic myotomy is possible treatment option for a pregnant woman with achalasia caused by mitochondrial disease.

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The objectiveof the study is to evaluate the safety and efficacy of the using of minimally invasive endoscopic methods in the treatment of submucosal esophageal tumors.Material and methods.The study included 89 patients with benign tumors of the esophagus. Endoscopic ultrasonography (EUS) was performed to determine the esophageal wall layer from which the tumor grows the size of the tumor and its relationship with the surrounding organs.Results.Submucosal tunneling resection was performed successfully in 73 patients. The average operation time was 84.5 minutes. In 16 patients, the tumor was removed by submucosal endoscopic dissection (SED). The average duration of ESD was 39.4 minutes. Among this group of patients we faced nonstandard cases of practical interest: leiomyomas of the upper part of the esophagus, plexiform leiomyomas and multiple leiomyomas. Each of the above types had its own specificity in diagnosis, treatment and postoperative management of patients.Conclusion.Submucosal esophageal tumors vary in types of growth, sizes, number of tumors, localization and its relationship with the surrounding organs. Scrupulous diagnosis of each case is necessary which will allow choosing the most appropriate treatment tactics for the patient.

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Submucosal tunneling endoscopic technique can be useful in obtaining esophageal muscle specimens in patients with esophageal motility disorders. Here, we describe the case of a patient with systemic sclerosis. Histological verification of the esophageal involvement in the pathological process was required for the treatment. There were no intra-and post-operational complications. Clin Endosc 2020;