V-05 Misconstruction during roux-en-y gastric bypass
| Autor: | Gabriel Menaldi, Juan Martin Riganti, Oscar Brasesco, Gaston Borlle, Mario Corengia |
|---|---|
| Rok vydání: | 2011 |
| Předmět: |
Heller myotomy
medicine.medical_specialty business.industry digestive oral and skin physiology Reflux Achalasia medicine.disease Roux-en-Y anastomosis Dysphagia digestive system diseases Surgery Hiatal hernia medicine.anatomical_structure Swallowing otorhinolaryngologic diseases medicine Esophagus medicine.symptom business |
| Zdroj: | Surgery for Obesity and Related Diseases. 7:356 |
| ISSN: | 1550-7289 |
| DOI: | 10.1016/j.soard.2011.04.135 |
| Popis: | describe the diagnosis and surgical management of a patient with achalasia 16 years after Vertical Banded Gastroplasty (VBG). Methods: A 40 year-old woman presented with a 3-month history of progressive dysphagia, reflux and chest pain with swallowing. Her past surgical history was significant for VBG in 1994 for morbid obesity. Her maximum weight loss was 27 kg. She underwent an esophageal manometry that showed a normal lower esophageal sphincter (LES) pressure with shortened LES relaxation, aperistalsis and spasmodic contractions of the esophagus with swallowing suggestive of type III achalasia. Barium swallow demonstrated a hiatal hernia with narrowing of the gastroesphageal junction and narrowing of the gastric lumen related to previous VBG. She was taken to the operating room and laparoscopic removal of the gastric band, repair of hiatal hernia, Heller myotomy and Roux-en-Y gastric bypass were performed. Results: Postoperative barium swallow study showed free passage of contrast into the gastric pouch and no leak. Her dysphagia and reflux resolved and she was able to tolerate a diet. The patient lost 1.8 kg. in the first postoperative month. Conclusion: Laparoscopic Heller myotomy and Roux-en-Y gastric bypass is a surgical alternative for the treatment of achalasia in patients with previous VBG. |
| Databáze: | OpenAIRE |
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