Iatrogenic Esophageal Perforation After Laparoscopic Heller’s Myotomy Treated Successfully with Endoscopic Stent: Case Report and Literature Review

Patient: Male, 37-year-old Final Diagnosis: Achalasia Symptoms: Dysphagia Medication:— Clinical Procedure: Laparoscopic surgery Specialty: Surgery OBJECTIVE: Unusual or unexpected effect of treatment BACKGROUND: Achalasia cardia is a neuro-degenerative motility disorder, which results in the loss of esophageal peristalsis along with failure of the lower sphincter to relax in response to swallowing. It is relatively rare, with a prevalence of 10 cases per 100 000 individuals. The criterion standard in the management of achalasia is laparoscopic Heller’s myotomy with partial fundoplication. Esophageal perforation is one of the earliest major complications that could be managed by primary repair. However, it has been reported that esophageal perforations in achalasia cases can be managed with esophageal stenting after primary repair failure. CASE REPORT: We are reporting a case of achalasia after Heller’s myotomy in a 37-year-old man, which was complicated by iatrogenic esophageal perforation and was successfully managed by esophageal stenting after failed primary repair. CONCLUSIONS: Esophageal stenting is a safe and effective management in cases of esophageal perforation after Heller’s myotomy procedure.