Shin SK, Kim KO, Kim EJ, Kim SY, Kim JH, Kim YJ, Chung JW, Kwon KA, Park DK. Peroral endoscopic myotomy for treatment of Guillain-Barre syndrome-associated achalasia: A rare case. World J Gastroenterol 2017; 23(5): 926-930 [PMID: 28223738 DOI: 10.3748/wjg.v23.i5.926]
Corresponding Author of This Article
Kyoung Oh Kim, MD, Department of Internal Medicine, Gachon University Gil Medical Center, 21, Namdone-daero 774 beon-gil, Namdong-gu, Incheon 21565, South Korea. kkoimge@naver.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Case Report
Open-Access Policy of This Article
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/
World J Gastroenterol. Feb 7, 2017; 23(5): 926-930 Published online Feb 7, 2017. doi: 10.3748/wjg.v23.i5.926
Peroral endoscopic myotomy for treatment of Guillain-Barre syndrome-associated achalasia: A rare case
Seung Kak Shin, Kyoung Oh Kim, Eui Joo Kim, Su Young Kim, Jung Ho Kim, Yoon Jae Kim, Jun-Won Chung, Kwang An Kwon, Dong Kyun Park
Seung Kak Shin, Kyoung Oh Kim, Eui Joo Kim, Su Young Kim, Jung Ho Kim, Yoon Jae Kim, Jun-Won Chung, Kwang An Kwon, Dong Kyun Park, Department of Internal Medicine, Gachon University Gil Medical Center, Incheon 21565, South Korea
Author contributions: Shin SK wrote the paper; Kim KO designed the report and reviewed the paper; Kwon KA and Park DK supervised the initial manuscript; Kim SY, Kim JH, Kim YJ and Chung JW contributed cases and edited the manuscript; Kim EJ participated to the medical care of the patient.
Institutional review board statement: This case report was exempt from the Institutional Review Board standards at Gachon University Gil Medical Center.
Informed consent statement: The patient involved in this study gave his written informed consent authorizing use and disclosure of his protected health information.
Conflict-of-interest statement: Authors have no conflict of interest to disclose.
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: Kyoung Oh Kim, MD, Department of Internal Medicine, Gachon University Gil Medical Center, 21, Namdone-daero 774 beon-gil, Namdong-gu, Incheon 21565, South Korea. kkoimge@naver.com
Telephone: +82-32-4603778 Fax: +82-32-4603408
Received: August 23, 2016 Peer-review started: August 24, 2016 First decision: September 28, 2016 Revised: October 6, 2016 Accepted: October 19, 2016 Article in press: October 19, 2016 Published online: February 7, 2017
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.
Core tip: Guillain-Barre’ syndrome (GBS)-associated achalasia is a rare disease of uncertain cause. Previously, a case of GBS-associated achalasia that was treated with pneumatic dilation was reported. However, pneumatic dilatation has about a 25%-50% chance that the patient will require another procedure within five years. Here, we present a case of a patient diagnosed with GBS-associated type I achalasia who was successfully treated with peroral endoscopic myotomy.
