Abstract:
Guillain-Barre syndrome (GBS)-associated achalasia is a very rare disease of uncertain cause. We report the case of a patient diagnosed with GBS-associated type I achalasia who was successfully treated with peroral endoscopic myotomy (POEM). A 30-year-old man who was diagnosed with GBS 3 mo before was referred to our department with dysphagia and meal-related regurgitation. The results of esophagography, endoscopy, and high-resolution manometry (HRM) revealed type I achalasia. POEM that utilized a submucosal tunneling technique was performed to treat the GBS-associated type I achalasia. After POEM, smooth passage of a contrast agent into the stomach was shown in follow-up esophagography, and follow-up HRM revealed a decrease in the mean integrated relaxation pressure 22.9 mmHg to 9.6 mmHg. The patient remained without dysphagia for 7 mo, even though the patient\'s neurological problems were not fully resolved. POEM may be a safe and effective treatment for GBS-associated type I achalasia.
摘要:
格林-巴利综合征(GBS)相关的门失弛缓症是一种非常罕见的疾病,原因不确定。我们报告了一例被诊断为GBS相关的I型门失弛缓症的患者,该患者通过经口内镜肌切开术(POEM)成功治疗。一名30岁的男子在3个月前被诊断为GBS,因吞咽困难和与进餐相关的反流而被转诊到我们部门。食管造影的结果,内窥镜检查,高分辨率测压(HRM)显示I型贲门失弛缓症。使用粘膜下隧道技术进行POEM治疗GBS相关的I型门失弛缓症。在POEM之后,随访食管造影显示造影剂顺利进入胃,随访HRM显示平均积分松弛压降低22.9mmHg至9.6mmHg。患者持续7个月没有吞咽困难,即使病人的神经问题没有完全解决。POEM可能是GBS相关的I型失弛缓症的安全有效的治疗方法。