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Obesity and symptomatic achalasia
Fernando Augusto Mardiros Herbella1, Jacques Matone, Laércio Gomes Lourenço
1Esophagus and Stomach Division, Department of Surgery, Escola Paulista de Medicina, UNIFESP, São Paulo, SP, Brazil. herbella.dcir@unifesp.epm.br
Obesity Surgery
|June 11, 2005
Summary
Symptomatic achalasia in a morbidly obese patient presented unique challenges, leading to a mental disorder post-surgery. Weight gain exacerbated symptoms, highlighting surgical risks in such cases.
Area of Science:
- Gastroenterology
- Bariatric Surgery
- Clinical Case Study
Background:
- Achalasia commonly causes weight loss due to dysphagia.
- Morbidly obese patients with achalasia manometrics are typically asymptomatic.
- This case presents a rare instance of symptomatic achalasia in a morbidly obese individual.
Observation:
- A 38-year-old woman with symptomatic achalasia and morbid obesity underwent esophageal myotomy and fundoplication.
- Postoperatively, a mental disorder manifested.
- Significant weight gain occurred, leading to the development of gastroesophageal reflux disease.
Findings:
- The coexistence of symptomatic achalasia and morbid obesity poses complex management challenges.
- Surgical intervention in this patient population can lead to unexpected complications, including mental health issues.
- Postoperative weight gain can precipitate or worsen gastroesophageal reflux disease.
Implications:
- Careful patient selection and psychological evaluation are crucial before bariatric or esophageal surgery in obese patients.
- Management strategies must address both achalasia and obesity-related complications.
- Further research is needed to understand the long-term outcomes and optimal surgical approaches for patients with comorbid achalasia and morbid obesity.