Esophageal Peroral Endoscopic Myotomy in a Young Patient with Type II Achalasia

Abstract Achalasia is a motor disorder of the esophagus characterized by incomplete relaxation of the lower esophageal sphincter and disordered esophageal peristalsis. Current treatments include pneumonic dilation, botulinum toxin injections, laparoscopic Heller myotomy, and esophageal peroral endoscopic myotomy (E-POEM). E-POEM is an advanced, minimally invasive non-surgical intervention for the treatment of achalasia. This procedure has repeatedly shown non-inferiority to the classic laparoscopic, surgical Heller myotomy, and is the preferred approach due to being an endoscopic procedure. In this article, we report a case of type II achalasia in a 21-year-old male that was treated by E-POEM which resulted in a significant reduction in Eckardt score and resolution of symptoms. Keywords: esophageal peroral endoscopic myotomy (E-POEM), achalasia, dysphagia.