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Peroral endoscopic Myotomy (POEM) – Achalasia Cardia

Peroral endoscopic Myotomy (POEM)

Background

43-year-old young male presented with persistent dysphagia and vomiting for one year.

Diagnosis and treatment:

Patient is diagnosed as a case Achalasia Cardia type II, for which he had undergone endoscopic balloon dilation. Since he had persistent symptoms, he was taken up for “Peroral Endoscopic Myotomy”, in which we reached gastroesophageal junction by creating submucosal tunnel.  Myotomy was done at gastroesophageal sphincter, lower part of esophagus and 2 cm distal to GE Junction. The patient was discharged. On follow up, the patient had improved symptomatically.

Peroral endoscopic Myotomy (POEM) - Achalasia Cardia

POEM – Mucosal incision

Peroral endoscopic Myotomy (POEM) - Achalasia Cardia

POEM – Submucosal tunnel

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