Gastroesophageal Intussusception Treated With Combined Transoral Incisionless Fundoplication in a Patient With Systemic Sclerosis

We present a case of a 49-year-old woman with diffuse cutaneous systemic sclerosis with refractory gastroesophageal reflux disease and dysphagia for pills and solid foods. Esophagogastroduodenoscopy revealed gastroesophageal intussusception. Despite several interventions including esophageal stent placement, dysphagia persisted. Owing to refractory severe symptoms, the patient underwent a laparoscopic hiatal hernia repair combined with endoscopic transoral incisionless fundoplication. The patient tolerated the intervention well and dysphagia resolved. Although an obscure persistent dysphagia in SSc patients, gastroesophageal intussusception should be considered. This case underscores the need for persistence in the diagnostic evaluation of gastrointestinal symptoms in patients with SSc and highlights the need for a multidisciplinary team care approach.