PDF(Pubmed)
Abstract：
Patients with both achalasia and decompensated cirrhosis can often present a therapeutic challenge because portal hypertension has generally been considered a contraindication to definitive therapies for achalasia. This case report depicts a patient who presented with progressive dysphagia, weight loss, and large-volume ascites; was diagnosed with type II achalasia and decompensated cirrhosis without esophageal varices; and underwent peroral endoscopic myotomy after preprocedural transjugular intrahepatic portosystemic shunt placement. Our case highlights the importance of multidisciplinary care and need for definitive therapies for these complex patients at high risk of malnutrition and sarcopenia.
摘要：
门失弛缓症和失代偿性肝硬化患者通常会面临治疗挑战，因为门脉高压通常被认为是门失弛缓症明确治疗的禁忌症。本病例报告描述了一名患者出现进行性吞咽困难，减肥,和大量腹水；被诊断为II型门失弛缓症和失代偿性肝硬化，无食管静脉曲张；术前经颈静脉肝内门体分流术后接受了经口内镜下肌切开术。我们的案例强调了多学科护理的重要性，以及对这些营养不良和肌少症高风险的复杂患者需要明确的治疗方法。
