Heller’s cardiomyotomy done for
Correct Answer: Achalasia
Description: Ans. (b) AchalasiaRef: Bailey and Love 27th Edition, Page 1098Treatment for Achalasia:There are various modes of treatment for achalasia cardia:Medical Treatment:* Calcium channel blockers like sublingual Nifedipine* Sildenafil citrate* NitratesEndoscopic Treatment:* Pneumatic balloon dilatation: 30mm - 40mm plastic balloon are used. Most common complication is perforation around 0.5%. Results are good for age above 40 years* Botulinum toxin: injected in the LOS which destroys the excitatory effect of cholinergic neurons. Effect is temporary and we have to repeat after few months. Hence used only for Unfit elderly patients.* Endoscopic myotomy known as peroral endoscopic myotomy (POEM)Heller's Myotomy:* Gold standard of all procedures. Myotomy done from 1-2 cm on stomach side extending up to 6-8 cm on esophagus side anteriorly* Most common complication is GERD* Hence nowadays Dor anterior fundoplication is done along with myotomy.* Successful in 90% cases.
Category:
Surgery
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