RESTORATION OF A RARE, IMPRESSIVE AESTHETIC CERVICAL DYSMORPHIA DUE TO OESOPHAGEAL ACHALASIA BY PERORAL ENDOSCOPIC MYOTOMY PROCEDURE

Aims:

An aesthetic advantage of peroral endoscopic myotomy procedure (POEM) on achalasic patients against surgical approaches, is the absence of abdominal or thoracic skin scars. The aim of this abstract is to present another impressive aesthetic result, succeeded via therapy of an achalasic patient with POEM, which simultaneously corrected an accompanied rare extensive aesthetic cervical dysmorphia, as well.

Methods:

Patient, a female 77 years old, presented with dysphagia, heartburn, regurgitation, retrosternal pain mainly during last year, and the above mentioned dysmorphic left cervical distention which was deteriorated in size by food intake, last month. The laboratory findings of oesophagogram, manometry and OGD reconfirmed the presence of achalasia. CT scan revealed a large oesophageal tube with significant tortuosity that caused an extreme anatomical deviation of aorta and neighbor anatomy, explaining the above mentioned dysmorphic picture. A successful anterior POEM was performed.

Results:

The second post procedural day the barium oesophagogram showed the easy emptying of barium through the LOS. Patient was able to swallow and was discharged on antibiotics and progressive diet. Seven days later the patient assured that cervical distention had completely disappeared, obviously due to the reduction of LOS pressure. On follow up, CT scans confirmed an impressive correction of the normal anatomy after 2 months and complete restoration after 12 months. Clinical as well aesthetic success is preserved, too.

Conclusions:

In conclusion, the aesthetic advantage of POEM is not limited only on the profound lack of skin scars but may also be expanded to other not expected accompanied situations, as above described.