Case Report
Copyright ©The Author(s) 2017.
World J Gastroenterol. Oct 7, 2017; 23(37): 6902-6906
Published online Oct 7, 2017. doi: 10.3748/wjg.v23.i37.6902
Table 1 Reported cases of achalasia after Roux-en-Y gastric bypass
CaseAge and genderPre-operative BMI (kg/m2)ProcedurePresentationOnset of symptoms postoperativeUpper GI series/Barium swallowEGDEsophageal manometryTreatment
Ramos et al[16] 200944-yr-old female47Laparoscopic RYGBDysphagia to solids, and regurgitation4 yrDilatedNormal gastroesophagealElevated resting LES pressure, aperistalsis, and hypo contractilityLaparoscopic Heller myotomy
esophagus, poor esophageal emptying, andjunction, a 4-cm gastric pouch without lesions, and a wideof the esophagus.
tapering of the LESgastrojejunostomy
Torghabeh et al[17] 201548-yr-old female44.75Laparoscopic RYGBDysphagia to solid, regurgitation, and chest pain5 yrDilated esophagus and stricture at the LESTortuous esophagus with retained food products and Candida plaques. Stricture was balloon dilatedElevated resting LES pressure, aperistalsis, and failure of LES relaxationLaparoscopic Heller myotomy
Chapman et al[18] 201353-yr-old femaleNAOpen PYGBEpigastric and LUQ pain and reflux symptoms2 yrDilated thoracic esophagus with reduced primary peristalsis. Contrast was slow to pass through the gastro-esophageal junctionDilated esophagus, esophagitis and ulceration above the gastro-esophageal junctionAbsence of LES relaxation and aperistalsisLaparoscopic Heller myotomy
Our case 201670-yr-old female52Laparoscopic RYGBRegurgitation, mild dysphagia, nausea and occasional vomiting2 yrPersistent narrowing of the gastroesophageal junction with a dilated, debris filled esophagus. Some tertiary contractionsDilated, tortuous esophagus that appeared as a "sigmoid esophagus" but no strictures or stenosis was noted.Elevated LES pressure with abnormal relaxation in addition to aperistalsis andScheduled for laparoscopic Heller myotomy