Published online Oct 7, 2017. doi: 10.3748/wjg.v23.i37.6902
Peer-review started: June 16, 2017
First decision: July 13, 2017
Revised: August 4, 2017
Accepted: August 15, 2017
Article in press: August 15, 2017
Published online: October 7, 2017
Achalasia is a rare esophageal motility disorder that is characterized by a loss of peristalsis in the distal esophagus and failure of lower esophageal sphincter relaxation. The risk of developing esophageal motility disorders, including achalasia, following bariatric surgery is controversial and differs based on the type of surgery. Most of the reported cases occurred with laparoscopic adjustable gastric banding. To our knowledge, there are only three reported cases of achalasia after Roux-en-Y gastric bypass and no reported cases after revision of the surgery. We present a case of a 70-year-old female who had a previous history of Roux-en-Y gastric bypass with revision. She presented with persistent nausea and regurgitation for one month. Esophagogastroduodenoscopy showed a dilated esophagus without strictures or stenosis. A barium study was performed after the endoscopy and was suggestive of achalasia. Those findings were confirmed by a manometry. The patient was referred for laparoscopic Heller’s myotomy.
Core tip: Achalasia is a rare esophageal motility disorder. It is uncommonly reported after bariatric surgeries. Achalasia is a very rare complication after Roux-en-Y gastric bypass. We report a case of a 70-year-old female who she presented with persistent nausea and regurgitation for one month. She had a previous history of Roux-en-Y gastric bypass with revision. As part of her inpatient evaluation, a computed tomography of the chest, a barium study and an upper endoscopy were suggestive of achalasia. Those findings were confirmed by a manometry. The patient was referred for laparoscopic Heller’s myotomy.