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Updated: Jun 26, 2025
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Robotic Myotomy and Partial Fundoplication for Achalasia
Published on: August 11, 2023
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Achalasia in pregnancy.
Zafirah Akmal Azahar1, Mohd Fadliyazid Ab Rahim1, Nasriah Ahmad1
1Ministry of Health Malaysia, Hospital Sultanah Nur Zahirah, Kuala Terengganu, Malaysia.
BMJ Case Reports
|May 15, 2024
Summary
Achalasia in pregnancy poses significant risks, leading to severe maternal and fetal complications like aspiration pneumonia and fetal growth restriction. Prompt management and delivery are crucial for improved outcomes.
Area of Science:
- Gastroenterology and Obstetrics
- Rare pregnancy complications
Background:
- Achalasia, a rare esophageal motility disorder, presents unique challenges during pregnancy due to potential fetomaternal risks.
- The condition involves impaired esophageal emptying and lower esophageal sphincter relaxation.
Observation:
- A 30-year-old pregnant patient at 35 weeks presented with respiratory distress and fever, secondary to vomiting and regurgitation.
- Initial diagnosis included aspiration pneumonia, metabolic acidosis, malnutrition, and fetal growth restriction.
Findings:
- Postpartum endoscopy confirmed achalasia.
- Delivery via Cesarean section was performed after clinical stabilization.
- Definitive surgical management was delayed until nutritional optimization.
Implications:
- This case highlights the critical, life-threatening complications of achalasia during pregnancy.
- Management requires a multidisciplinary approach, balancing maternal and fetal well-being.
- Timely diagnosis and intervention are essential for managing this rare obstetric complication.
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