Patient Thanh Nhan ( Patient's name has been changed, 45 years old, Hanoi) after many years of suffering from appetite cramps, the patient fell into a state of unable to eat or drink, severe weight loss and was discovered to have an Esophagus extended to 7 cm.
Patient Nhan shared that she was diagnosed with appetite cramps 7 years ago and had gone through two phlegm in her esophagus. However, recently, symptoms have become more severe with symptoms of choking, nausea, poor appetite, a short-term loss of 5 kg and exhaustion, requiring a wall to move. Ms. Nhan went to Tam Anh General Hospital, Ho Chi Minh City for a check-up.
The results of an esophagogastric X-ray with an optical barrier showed that the esophagus was 7 cm wide (usually about 1.5 cm), with food and fluid stagnant inside. Results of the Esophagic Pressure Measurement using the High-D processor System (HRM) showed that the patient had under-esophagic muscle contraction and stretching disorders, which are characteristic of cardiopulmonary cramps.
Dr. Do Minh Hung - Director of the Center for Endoscopy and Gastroenterological Endoscopy Surgery, Tam Anh General Hospital, Ho Chi Minh City, said that the patient had severe type II cosmetic conjunctivitis, which was no longer suitable for treatment of phlegm due to the esophagus being too large. Oral coronary artery bypass surgery (POEM) is also not feasible due to the high risk of complications in cases of expanded esophagus and prolonged surgery.
After consultation, the patient was prescribed endoscopic surgery using the Heller technique of cutting the lower esophageal laryngoplasty muscle through the abdomen. This is a method to help reduce pressure on the circulatory muscles, while combining the creation of an anti-inflammatory valve to limit complications after surgery. During the surgery, the doctors noted that the esophagus was dilated, the stomach lining was stuck to the spleen, and had to remove the sticking and cut the waistline about 8 cm long, preserve the mucous layer and reshaping the valve.
After surgery, the X-ray results showed that the esophagus was circulating well, with no more stagnation of water and food. The patient was no longer choking and was discharged after a day of monitoring. Patients are recommended to eat loosely for 5-7 days and gradually switch to a solid diet afterwards.
According to Dr. Minh Hung, appendicitis (achalasia) is a disease of Esophageal Mobilization Disorder, in which the lower ring muscles do not open properly, causing food to stagnate, causing Esophageal expansion for a long time, chest pain, weight loss and esophageal ulcers. The cause of the disease is not clear, it may be related to genetic factors, infections, prolonged stress, smoking, alcohol...
The disease can occur at any age but is common in middle-aged people. If not treated promptly, the disease can lead to serious complications such as pneumonia, irreversible esophageal dilation or esophageal cancer.
Experts recommend that when symptoms of choking, chest pain, and weight loss of unknown cause appear, patients need to see a doctor early for proper diagnosis and treatment, to avoid the disease from getting worse and affecting their quality of life.
