Achalasia cardia with esophageal varix managed with endoscopic ultrasound-guided botulinum toxin injection.
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Date
2011-11
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Abstract
Achalasia cardia is a motility disorder of the esophagus characterized by failure of relaxation of the lower esophageal sphincter. Nitrates and calcium channel blockers,
pneumatic dilatation, botulinum toxin injection and surgical
myotomy have been described in literature as possible management
options. We present a patient who presented with
achalasia and was co-incidentally diagnosed to have cryptogenic
cirrhosis with portal hypertension and had esophageal
varices. This clinical combination precluded the use of pneumatic
dilatation and surgical myotomy.We injected botulinum
toxin into the lower esophageal sphincter using a celiac plexus neurolysis needle under endoscopic ultrasound guidance; the clinical response was good.
Description
Keywords
Achalasia, Endoscopic ultrasound, Esophageal varices
Citation
Lakhtakia Sandeep, Monga Amitabh, Gupta Rajesh, Kalpala Rakesh, Pratap Nitesh, Wee Eric, Arjunan Saravanan, Reddy D Nageshwar. Achalasia cardia with esophageal varix managed with endoscopic ultrasound-guided botulinum toxin injection. Indian Journal of Gastroenterology. 2011 Nov-Dec; 30(6): 277-279.