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