Self-expandable metal stent placement in a child for treatment of achalasia after failed Heller myotomy

Self-expandable metal stent placement in a child for treatment of achalasia after failed Heller myotomy

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Background and study aims Childhood achalasia treatment remains inconclusive.What is next after myotomy failure? Repeated pneumatic-dilation put patients at greater risk of perforation with possible symptom recurrence.We report on a 12-year-old patient with a 1-year history of achalasia whom underwent Heller eagles head coach hoodie myotomy with fundoplication and recurred with symptoms 1 week after surgery.Pneumatic dilatation was considered but not done because of the risk of esophageal perforation.

The decision was made to place a fully covered self-expanding metallic stent (FC-SEMS) for 3 months, which resolved the stenosis as confirmed by esophagram.The patient has remained asymptomatic since the procedure was elliot pecan tree for sale performed 2 years ago.FC-SEMS is an alternative for treatment of refractory achalasia in children who do not respond to conventional treatment.