Acta Medica Okayama 72巻 6号
2018-12 発行

A Case of Diffuse Esophageal Spasm Treated with Peroral Endoscopic Myotomy

Sugihara, Yuusaku Department of Gastroenterology and Hepatology, Okayama University Hospital
Harada, Keita Department of Gastroenterology and Hepatology, Okayama University Hospital
Kato, Ryo Department of Gastroenterology and Hepatology, Okayama University Hospital
Yamauchi, Kenji Department of Gastroenterology and Hepatology, Okayama University Hospital
Sakae, Hiroyuki Department of Gastroenterology and Hepatology, Okayama University Hospital
Kawano, Seiji Department of Gastroenterology and Hepatology, Okayama University Hospital
Hiraoka, Sakiko Department of Gastroenterology and Hepatology, Okayama University Hospital
Kawahara, Yoshiro Division of Endoscopy, Okayama University Hospital
Otsuka, Fumio Department of General Medicine, Okayama University Hospital
Okada, Hiroyuki Department of Gastroenterology and Hepatology, Okayama University Hospital
Publication Date
2018-12
Abstract
The indications for peroral endoscopic myotomy (POEM) have been expanded to include diffuse esophageal spasm (DES). A 67-year-old Japanese man presented with a 4-year history of dysphagia. Endoscopy and upper gastrography revealed abnormal peristaltic movements involving interruption of normal peristalsis, and a diverticulum located at the 2 o’clock esophageal position. High-resolution manometry indicated DES. POEM with a long (15 cm) myotomy was performed for the abnormal contractions, which subsequently disappeared along with dysphagia improvement. Our results suggest that esophageal motility disorders accompanying a diverticulum may be eliminated by POEM without treating the diverticulum itself. We speculate that POEM ameliorates esophageal diverticulum by reducing internal esophageal pressure.
Document Type
Case Report
Keywords
diffuse esophageal spasm (DES)
diverticulum, peroral endoscopic myotomy (POEM)
high-resolution manometry (HRM)
Link to PubMed
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