| Autor: |
Suprapto, Bambang, Aswin, Amalia |
| Zdroj: |
International Journal of Surgery Case Reports; 2020, Vol. 75, p252-257, 6p |
| Abstrakt: |
• Achalasia is a rare motor disorder of the oesophagus. • Achalasia is thought to arise from organ-specific autoimmunity due to vitiligo that present in the patient. • Clinical awareness is imperative when approaching an achalasia due to its similar symptom to GERD and respiratory disease, and must always be considered in autoimmune patient. • We performed Laparoscopic Heller's myotomy and repaired with Dor's fundoplication. Achalasia is a rare motor disorder of the oesophagus that typically characterized by the absence of oesophagus peristalsis and failure of swallow induced relaxation of oesophagus sphincter (LOS). The prevalence of achalasia is eight cases per million population. A 35-year-old woman presented with progressive dysphagia for 6 years. Her symptoms worsened in the last 14 days followed by vomiting undigested and retained food. She was previously diagnosed with a variant respiratory problem but her symptoms did not improve with medication. Clinical evaluation and investigation revealed features of multiple depigmented patches with sharply defined borders and leucotrichia on the neck, abdomen, hand, knee, and lateral malleolus. The patient had vitiligo for 18 years. The upper gastrointestinal endoscopy showed the dilatation from distal oesophagus (38 cm from incisors) with retained food. The diagnosis of achalasia was given. After laparoscopic Heller's myotomy was performed and the opening of the oesophagus was repaired with Dor's fundoplication, her symptoms were much improved. We hereby report on a rare case of achalasia in a woman presenting with vitiligo which may suggest an autoimmune disorder in the onset of achalasia. Achalasia must be considered in vitiligo or any autoimmune disease presenting with the oesophagus-related problem. [ABSTRACT FROM AUTHOR] |
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