Hydrostatic balloon dilation under X-ray control advantages and disadvantages over surgical treatment in achalasia - technical performance and results
DOI:
https://doi.org/10.5281/zenodo.14869112Keywords:
achalasia, manometry, balloon dilatation, laparoscopic myotomyAbstract
INTRODUCTION: Achalasia is a chronic incurable esophageal motility disorder characterized by impaired lower esophageal sphincter (LES) relaxation and loss of esophageal peristalsis. Although rare, it is currently the most common primary esophageal motility disorder, with an annual incidence of around 1.6 per 100,000 persons and prevalence of around 10.8/100,000 persons. Symptoms of achalasia include dysphagia to both solids and liquids, regurgitation, aspiration, chest pain and weight loss. As the underlying etiology of achalasia remains unclear, there is currently no curative treatment for achalasia. Management of achalasia mainly involves improving the esophageal outflow in order to provide symptomatic relief to patients.This case aims to demonstrate the advantages of balloon hydrostatic dilatation over surgical treatment.
CLINICAL CASE: A 58-year-old woman entered a surgery clinic with complaints of dysphagia, heaviness after feeding and persistent vomiting for months. The patient has a pronounced consumptive syndrome - 15 kg in 1 year. There is a proven gallstone disease with a crisis-pain form. We concluded the diagnosis by performing esophagogastroscopy, x-ray contrast examination of the esophagus and stomach and esophageal manometry. We present to you treatment with hydrostatic dilatation of the LES and the advantages over surgical treatment.
CONCLUSION: Achalasia is a chronic primary esophageal motility disorder causing symptoms of dysphagia, regurgitation, chest pain and weight loss. Treatment for achalasia is mainly focused on improving esophageal emptying in order to provide symptomatic relief to patients. Hydrostatic dilation is a method in which precise and controlled dilation of the sphincter is performed, avoiding the frequent complications such as excessive dilatation and rupture associated with surgical treatment, and is characterized by a shorter hospital stay and a painless recovery period.
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