Intrasphincteric Botulinum Toxin Injections to Treat Achalasia Diagnosed in 615 Pregnancy: A Case Report.

IF 0.2 4区 医学 Q4 Medicine 生殖医学杂志 Pub Date : 2016-11-01
Nicolette Holliday, Susan Baker
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引用次数: 0

Abstract

Background: Achalasia is an esophageal smooth muscle disorder characterized by failure of the lower esophageal sphincter to relax with swallowing.

Case: A 17-year-old primigravid woman with an intrauterine pregnancy at 31+3 weeks reported an unintentional 22.5 kg weight loss in 2 years. Her body mass index was 15.9. Her symptoms included nausea, regurgitation, and worsening dysphagia. MRI suggested achalasia. She was started on total parenteral nutrition until she developed bacteremia. An esophagogastroduodenoscopy with Duotube placement and botulinum toxin A injections were performed. Tube feeds were initiated and continued until the Duotube became obstructed. The patient delivered at 37+4 weeks with mild preeclampsia. A postpartum barium swallow test indicated achalasia.

Conclusion: A history of dysphagia to solids and/or liquids with weight loss should raise clinical suspicions for achalasia.

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输注肉毒毒素治疗615例妊娠贲门失弛缓症1例报告。
背景:贲门失弛缓症是一种食管平滑肌疾病,其特征是食管下括约肌在吞咽时不能放松。病例:一名17岁的初孕妇女在宫内妊娠31+3周时报告在2年内意外体重减轻22.5公斤。她的体重指数为15.9。她的症状包括恶心、反流和吞咽困难加重。MRI提示失弛缓症。她开始接受全肠外营养,直到出现菌血症。进行食管胃十二指肠镜检查,放置十二指肠管并注射A型肉毒杆菌毒素。开始并继续管饲,直到十二指肠管阻塞。患者于37+4周分娩,伴有轻度子痫前期。产后钡餐检查显示失弛缓症。结论:有固体和/或液体吞咽困难史且体重减轻的患者应提高对失弛缓症的临床怀疑。
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来源期刊
生殖医学杂志
生殖医学杂志 医学-妇产科学
自引率
0.00%
发文量
6427
审稿时长
6-12 weeks
期刊介绍: The Journal of Reproductive Medicine® has been the essential tool of Obstetricians and Gynecologists since 1968. As a highly regarded professional journal and the official periodical of six medical associations, JRM® brings timely and relevant information on the latest procedures and advances in the field of reproductive medicine. Published bimonthly, JRM® contains peer-reviewed articles and case reports submitted by top specialists. Common topics include research, clinical practice, and case reports related to general obstetrics and gynecology, infertility, female cancers, gynecologic surgery, contraception, and medical education.
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