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DOI: 10.1055/s-0040-1704516
FLUOROSCOPY GUIDED POEM IN A SIGMOID ESOPHAGUS
Publikationsverlauf
Publikationsdatum:
23. April 2020 (online)
Background Tunneling could be complicated in cases of esophageal tortuosity.
A 32 years female with long history type I Achalasia with previous Heller. Clinical relapse and radiologic Sigmoid Esophagus.
Endoscopic findings POEM performed in supine. Mucosotomy with muscularis mucosa thickening. During tunneling, detour is notice and the path corrected following the circular muscularis propria fibers and checking esophageal tunnel lifting. Following, penetrating vessels are seen interpreted as the tunnel end. Due to tortuosity, fluoroscopy is used to confirm endoscope strengthened position. Myotomy and mucosal closure is performed.
Conclusions Fluoroscopy and circular muscularis propria fibers could be guides in sigmoid Esophagus during POEM.