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Successful surgical treatment for diffuse esophageal spasm
Kiyotomi Maruyama1, Satoru Motoyama, Manabu Okuyama
1From Department of Gastroenterological Surgery, Akita University School of Medicine, Akita, Japan.
The Japanese Journal of Thoracic and Cardiovascular Surgery : Official Publication of the Japanese Association for Thoracic Surgery = Nihon Kyobu Geka Gakkai Zasshi
|April 15, 2005
Summary
A surgical approach called long myotomy effectively treated severe diffuse esophageal spasm (DES) in a patient resistant to medication. This procedure relieved dysphagia and improved the patient's condition.
Area of Science:
- Gastroenterology
- Surgical Gastroenterology
Background:
- Diffuse esophageal spasm (DES) is a primary esophageal motility disorder.
- Severe dysphagia and weight loss can be debilitating symptoms of DES.
Observation:
- A 74-year-old man with a history of gastric cancer presented with severe dysphagia and weight loss.
- Barium swallow revealed a corkscrew esophagus, characteristic of DES.
- Esophageal manometry confirmed intermittent, simultaneous, high-amplitude contractions.
Findings:
- Long esophagomyotomy with fundoplication was performed due to medication ineffectiveness.
- The myotomy extended superiorly to the aortic arch and inferiorly into the cardiac portion.
- Postoperative fluoroscopy showed resolution of spastic changes and improved clinical signs.
Implications:
- Long esophagomyotomy with antireflux surgery is a recommended treatment for severe DES unresponsive to conservative measures.
- This surgical intervention can effectively alleviate dysphagia and improve quality of life in DES patients.