Recurrent sub-mucosal dissection of the oesophagus in association with achalasia

Hooper, Timothy L.; Gholkar, J.; Smith, S. R.; Manns, J. J.; Moussalli, H

doi:10.1136/pgmj.62.732.955

Cited by 6 publications

(7 citation statements)

References 5 publications

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“… 5 , 6 , 7 , 8 , 9 Of the five cases previously reported, two were treated with Heller's myotomy, one with surgery, one with endoscopic dilatation, and one with medication. One case treated with Heller's myotomy showed recurrence of EIH after 15 months, 5 and one with medication showed recurrence of EIH after 7 years. 8 Our study is the first to report on POEM for achalasia with EIH.…”

Section: Discussionmentioning

confidence: 99%

“…Accordingly, we thought we did not have to wait for the complete ulcer healing to perform POEM. In addition, considering that there have been some reports on the recurrence of EIH on achalasia, 5 , 6 POEM may also contribute in preventing the recurrence of the intramural hematoma.…”

Section: Discussionmentioning

confidence: 99%

“… 3 The underlying etiology or predisposing factors were reported to be esophageal instrumentation, vomiting, trauma, pill‐induced injury, food impaction‐related issue, or coagulation defects. 4 However, reports of EIH on achalasia patients are quite limited, 5 , 6 , 7 , 8 , 9 and POEM procedure for achalasia with EIH has not been reported.…”

Section: Introductionmentioning

confidence: 99%

“…Chest and abdominal CT image of the esophageal intramural hematoma (EIH), which is a slight hyperdense mass in the dilated esophagus (e and f) or coagulation defects. 4 However, reports of EIH on achalasia patients are quite limited, [5][6][7][8][9] and POEM procedure for achalasia with EIH has not been reported.…”

Section: Introductionmentioning

confidence: 99%

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Achalasia with esophageal intramural hematoma treated by per‐oral endoscopic myotomy (POEM)

Fujiyoshi

Kimura

et al. 2021

DEN Open

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Esophageal intramural hematoma (EIH) is a condition which occurs as a result of hemorrhage within the esophageal wall including the submucosal layer. However, reports of EIH on achalasia patients are quite limited and per‐oral endoscopic myotomy (POEM) for achalasia with EIH has not been reported. This is the first case report that demonstrated a successful treatment of achalasia with EIH by POEM. In achalasia, since there is absence of lower esophageal sphincter relaxation, as barotraumatic pathogenesis, an increase in the intraesophageal pressure may cause EIH. As direct traumatic pathogenesis, the stasis of food may directly injure the esophageal wall resulting in EIH. After confirming the hematoma healed until it became an ulcer, POEM was performed on the posterior axis since the intramural hematoma was located anteriorly. The procedure was completed successfully without any occurrence of adverse events. On 2‐months follow‐up, improvement in dysphagia was noted, and complete epithelialization of the intramural hematoma region was seen on endoscopic examination. On 1‐year follow‐up, patient did not have recurrence of dysphagia and intramural hematoma. In summary, we reported a case of achalasia with EIH, which was treated by POEM. POEM procedure may be effective not only for the improvement of dysphagia but also for a better ulcer healing and prevention of intramural hematoma recurrence.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Achalasia with esophageal intramural hematoma treated by per‐oral endoscopic myotomy (POEM)

Fujiyoshi

Kimura

et al. 2021

DEN Open

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“…Most patients recover spontaneously and death is rare after operative intervention and usually in terminally ill patients 5,6 . Long‐term complications are not expected but recurrence was reported in one patient with achalasia 25 . Repeated contrast studies or endoscopy can be done to demonstrate complete resolution and to exclude the presence of an underlying pathology such as malignant tumor of the esophagus.…”

Section: Discussionmentioning

confidence: 99%

Esophageal hematoma

Tong¹,

Hung²,

Law³

et al. 2006

Diseases of the Esophagus

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Hematoma of the esophagus is an uncommon condition. Patients often present with acute odynophagia or retrosternal pain, which may be confused with other diagnoses. We report herein two patients with esophageal hematoma caused by foreign body ingestion. Conservative treatment resulted in complete resolution. The literature is reviewed for the etiology, clinical features and management of this condition.

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Southwestern Internal Medicine Conference: Esophageal Achalasia Syndromes

Feldman

1988

The American Journal of the Medical Sciences

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Recurrent sub-mucosal dissection of the oesophagus in association with achalasia

Abstract: Summary:Submucosal dissection of the oesophagus is a rare oesophageal disorder. We report a patient who had recurrent episodes of dissection and achalasia. Both recurrence and the association with achalasia are to our knowledge unique.

Cited by 6 publications

References 5 publications

Achalasia with esophageal intramural hematoma treated by per‐oral endoscopic myotomy (POEM)

Achalasia with esophageal intramural hematoma treated by per‐oral endoscopic myotomy (POEM)

Esophageal hematoma

Southwestern Internal Medicine Conference: Esophageal Achalasia Syndromes

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