Case Report
Copyright ©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Oct 7, 2017; 23(37): 6902-6906
Published online Oct 7, 2017. doi: 10.3748/wjg.v23.i37.6902
Achalasia after bariatric Roux-en-Y gastric bypass surgery reversal
Mouhanna Abu Ghanimeh, Ayman Qasrawi, Omar Abughanimeh, Sakher Albadarin, Wendell Clarkston
Mouhanna Abu Ghanimeh, Division of Gastroenterology, Henry Ford Hospital, Detroit, MI 48202, United States
Ayman Qasrawi, Omar Abughanimeh, Wendell Clarkston, Department of Internal Medicine, University of Missouri-Kansas City, Kansas City, MO 64108, United States
Sakher Albadarin, Wendell Clarkston, Division of Gastroenterology, Saint Luke’s Hospital of Kansas City, Kansas City, MO 64111, United States
Author contributions: All authors contributed to the manuscript; Abu Ghanimeh M, Qasrawi A and Abughanimeh O wrote the manuscript; Albadarin S edited the initial manuscript draft and provided the images; Clarkston W reviewed, edited and approved the final manuscript.
Institutional review board statement: This is a case report and IRB approval is not required.
Informed consent statement: The patient has provided permission to publish these features of his case, and the identity of the patient has been protected.
Conflict-of-interest statement: No conflict-of-interest.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Mouhanna Abu Ghanimeh, MD, Gastroenterology fellow, Henry Ford Health System, 2799 W Grand Blvd, Gastroenterology K-7 Room E-744, Detroit, MI 48202, United States. mabugh1@hfhs.org
Telephone: +1-816-328-4088 Fax: +1-313-9166413
Received: June 15, 2017
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
Abstract

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.

Keywords: Esophagus, Bariatric, Gastric band, Bypass surgery, Achalasia, Esophagogastroduodenoscopy, Heller’s myotomy, Motility disorder

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.