# Peroral Endoscopic Myotomy (POEM) for Achalasia Cardia: A Report of Two Cases

## TL;DR

This paper reports the first successful use of a new esophageal procedure in Nepal for treating a swallowing disorder.

## Contribution

The first successful implementation of POEM for achalasia cardia in a resource-limited country.

## Key findings

- POEM was successfully performed on two patients with achalasia cardia in Nepal.
- The procedure was safe and effective in a resource-limited setting.
- This marks the first use of POEM in Nepal.

## Abstract

Achalasia cardia is a motility disorder of the esophagus characterized by a lack of esophageal peristalsis and failure of lower esophageal sphincter opening during swallowing. Symptomatic patients present with a long history of difficulty swallowing, along with chest pain and vomiting.

Two male patients, 55 and 24 years old, with proven achalasia cardia by high-resolution esophageal manometry (HRM), underwent a successful peroral endoscopic myotomy (POEM) procedure at our center. This was the first time this procedure was done in Nepal. In this case report, we have demonstrated that a novel third-space procedure like POEM can be safely performed in a resource-limited country.