ASGE Esophagology General GI Practice Virtual Program (LIVE Virtual) | April 2021-Case Discussion 2

Video Transcription

Video Summary

In this video, a panel discussion is being held with gastroenterology experts who are discussing the case of a 25-year-old male patient who has undergone multiple myotomies for achalasia. The patient presents with recurrent symptoms of dysphagia and chest pain. The experts discuss potential causes of the symptoms, such as recurrent achalasia, post-myotomy reflux, or strictures. The patient undergoes various tests, including manometry, esophagram, and endoscopy with flip. Based on the results, it is determined that the patient has incomplete myotomies and fibrosis at the gastroesophageal junction. The patient is offered a Poem (Peroral Endoscopic Myotomy) procedure as treatment. The panel also discusses the challenges of performing Poem after previous surgeries and the importance of a complete myotomy. Despite the difficulty of the procedure, the patient undergoes Poem and achieves a successful outcome. The panel suggests conducting a repeat flip and emptying study to assess the effectiveness of the procedure.

Asset Subtitle

Panel: Reginald Bell, Philip Katz, Peter Kahrilas, Amit Maydeo and Prateek Sharma

Keywords

achalasia

myotomies

recurrent symptoms

Poem procedure

fibrosis

complete myotomy