Iatrogenic Esophageal Perforation After Laparoscopic Heller's Myotomy Treated Successfully with Endoscopic Stent: Case Report and Literature Review. 2021

Ghadeer M AlHajjaj, and Fatimah Yasser AlTaweel, and Roaya Ahmed AlQunais, and Zahra H Alshammasi, and Saeed J Alshomimi
Department of Surgery, College of Medicine, King Fahad Hospital of the University, Imam Abdulrahman bin Faisal University, Khobar, Saudi Arabia.

BACKGROUND Achalasia cardia is a neuro-degenerative motility disorder, which results in the loss of esophageal peristalsis along with failure of the lower sphincter to relax in response to swallowing. It is relatively rare, with a prevalence of 10 cases per 100 000 individuals. The criterion standard in the management of achalasia is laparoscopic Heller's myotomy with partial fundoplication. Esophageal perforation is one of the earliest major complications that could be managed by primary repair. However, it has been reported that esophageal perforations in achalasia cases can be managed with esophageal stenting after primary repair failure. CASE REPORT We are reporting a case of achalasia after Heller's myotomy in a 37-year-old man, which was complicated by iatrogenic esophageal perforation and was successfully managed by esophageal stenting after failed primary repair. CONCLUSIONS Esophageal stenting is a safe and effective management in cases of esophageal perforation after Heller's myotomy procedure.

UI MeSH Term Description Entries
D007049 Iatrogenic Disease Any adverse condition in a patient occurring as the result of treatment by a physician, surgeon, or other health professional, especially infections acquired by a patient during the course of treatment. Hospital-Acquired Condition,Condition, Hospital-Acquired,Conditions, Hospital-Acquired,Disease, Iatrogenic,Diseases, Iatrogenic,Hospital Acquired Condition,Hospital-Acquired Conditions,Iatrogenic Diseases
D008297 Male Males
D010535 Laparoscopy A procedure in which a laparoscope (LAPAROSCOPES) is inserted through a small incision near the navel to examine the abdominal and pelvic organs in the PERITONEAL CAVITY. If appropriate, biopsy or surgery can be performed during laparoscopy. Celioscopy,Laparoscopic Surgical Procedures,Peritoneoscopy,Surgical Procedures, Laparoscopic,Laparoscopic Assisted Surgery,Laparoscopic Surgery,Laparoscopic Surgical Procedure,Procedure, Laparoscopic Surgical,Procedures, Laparoscopic Surgical,Surgery, Laparoscopic,Surgical Procedure, Laparoscopic,Celioscopies,Laparoscopic Assisted Surgeries,Laparoscopic Surgeries,Laparoscopies,Peritoneoscopies,Surgeries, Laparoscopic,Surgeries, Laparoscopic Assisted,Surgery, Laparoscopic Assisted
D004931 Esophageal Achalasia A motility disorder of the ESOPHAGUS in which the LOWER ESOPHAGEAL SPHINCTER (near the CARDIA) fails to relax resulting in functional obstruction of the esophagus, and DYSPHAGIA. Achalasia is characterized by a grossly contorted and dilated esophagus (megaesophagus). Achalasia, Esophageal,Cardiospasm,Megaesophagus,Achalasia,Achalasias,Achalasias, Esophageal,Cardiospasms,Esophageal Achalasias
D004939 Esophageal Perforation An opening or hole in the ESOPHAGUS that is caused by TRAUMA, injury, or pathological process. Esophageal Perforations,Perforation, Esophageal,Perforations, Esophageal
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000074434 Heller Myotomy Surgical incision of the lower esophageal sphincter near the CARDIA often used to treat ESOPHAGEAL ACHALASIA. Heller Groeneweldt Operation,Heller Groeneweldt Surgery,Heller Operation,Heller's Myotomy,Laparoscopic Heller Cardiomyotomy,Laparoscopic Heller Myotomy,Heller Myotomy, Laparoscopic,Myotomy, Heller,Myotomy, Heller's
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults
D015607 Stents Devices that provide support for tubular structures that are being anastomosed or for body cavities during skin grafting. Stent
D016896 Treatment Outcome Evaluation undertaken to assess the results or consequences of management and procedures used in combating disease in order to determine the efficacy, effectiveness, safety, and practicability of these interventions in individual cases or series. Rehabilitation Outcome,Treatment Effectiveness,Clinical Effectiveness,Clinical Efficacy,Patient-Relevant Outcome,Treatment Efficacy,Effectiveness, Clinical,Effectiveness, Treatment,Efficacy, Clinical,Efficacy, Treatment,Outcome, Patient-Relevant,Outcome, Rehabilitation,Outcome, Treatment,Outcomes, Patient-Relevant,Patient Relevant Outcome,Patient-Relevant Outcomes

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