Laparoscopic Heller’s cardiomyotomy and fundoplication; A successful approach for Achalasia Management at Muhimbili National Hospital, Tanzania: A cases series | ||||
| African Journal of Gastroenterology and Hepatology | ||||
| Volume 7, Issue 1, 2024, Page 272-280 PDF (632.9 K) | ||||
| Document Type: Case Reports | ||||
| DOI: 10.21608/ajgh.2024.387016 | ||||
 View on SCiNiTO | ||||
| Authors | ||||
Kitembo Salum Kibwana  ; Jenikalo Kaguo; Mohammed Sultan Salim; Godfrey Mchele; William Lutege; Yona E Ringo
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| Department of Surgery- Gastroenterology Unit, Muhimbili National Hospital, Dar-es-salaam, Tanzania. | ||||
| Abstract | ||||
| Aims: To describe the surgical management and outcomes of pediatric achalasia in two patients with rare comorbidities, focusing on the challenges and limitations in a resource-limited setting. Patients & Methods: This case series includes a 9-year-old male with Triple-A syndrome and a 7-year-old male with Addison’s disease, both presenting with long-standing dysphagia. Both patients underwent laparoscopic Heller’s myotomy and Dor fundoplication. The diagnosis was primarily based on clinical presentation and barium swallow due to the unavailability of esophageal manometry. Results: Both patients demonstrated significant improvements in dysphagia postoperatively. No intraoperative complications occurred, and neither patient experienced recurrence or complications at follow-up. However, the lack of manometric studies may have affected diagnostic precision. Conclusions: This case series highlights the effective use of laparoscopic Heller’s myotomy in pediatric achalasia patients with complex comorbidities. The absence of manometric studies and Per-Oral Endoscopic Myotomy options underscores the need for advanced diagnostic tools and surgical techniques in resource-limited settings. | ||||
| Keywords | ||||
| Achalasia; Pediatric Surgery; Laparoscopic Heller’s Myotomy; Dor Fundoplication; Triple-A Syndrome; Addison’s Disease; Esophageal Motility Disorders; Barium Swallow; Resource-Limited Settings; Surgical Outcomes | ||||
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