ASGE Endoscopy Live: Management of Achalasia (On-Demand) | April 2023-Case Demonstration 3

Video Transcription

Video Summary

In this video demonstration, Dr. Michael Bezzi from Vanderbilt University Medical Center explains pneumatic dilation, a procedure used to treat patients with achalasia. He is joined by Dr. Patel and Dr. Naik, along with their medical team. They discuss the clinical history of a 49-year-old female patient who has been experiencing dysphagia, regurgitation, and other symptoms since January 2022. The patient has previously undergone multiple endoscopy with dilation procedures at another hospital without improvement. They perform a barium esophagram and high-resolution manometry to confirm the diagnosis of achalasia. Based on predictive factors, such as the patient's age, gender, barium esophagram results, and narrow esophagus, they determine that pneumatic dilation would be a suitable treatment option. They proceed with the procedure and use endoscopic guidance to position and inflate a 3 cm balloon at the lower esophageal sphincter (LES). They monitor the patient for any signs of perforation post-procedure. The doctors also discuss the benefits and considerations of using endoscopic guidance versus fluoroscopic guidance for this procedure. They emphasize the importance of tailoring treatment options to individual patients and their preferences. The video concludes with a discussion among the doctors about the use of different balloon sizes and when to consider other treatment options like POEM (peroral endoscopic myotomy) or heller myotomy. Overall, the video provides a detailed overview of the pneumatic dilation procedure and highlights the importance of patient-centered care and expertise in performing the procedure. No specific credits were mentioned in the video.

Keywords

pneumatic dilation

achalasia

Vanderbilt University Medical Center

dysphagia

regurgitation

barium esophagram

high-resolution manometry