Jejunal Interposition with Overlap Esophago-Jejunal Anastomosis for an Esophageal Stricture due to Repeated Endoscopic Dilation for Esophageal Achalasia: A Case Report

TL;DR

A 67-year-old man with esophageal achalasia and stricture was successfully treated with a surgical technique involving jejunal interposition and overlap anastomosis.

Contribution

The overlap esophago-jejunal anastomosis technique is presented as an effective solution for esophageal stricture in achalasia.

Findings

The overlap technique allowed for additional resection of endoluminal muscle, improving outcomes.

The patient experienced unremarkable recovery and resolution of dysphagia after the procedure.

Abstract

Achalasia is a primary esophageal motility disorder of unknown origin. The clinical manifestations are caused by the loss of peristalsis of the esophagus and functional obstruction at the esophagogastric junction. There are several treatment strategies for esophageal achalasia, such as medications, endoscopic treatment, and surgery. The successful treatment of a case of jejunal interposition surgery with overlap esophago-jejunal anastomosis for an esophageal stricture due to repeated endoscopic dilation for esophageal achalasia is reported.

The patient was a 67-year-old man who was diagnosed with esophageal achalasia 13 years earlier. Partial esophagectomy of the portion with the stricture and esophago-jejunal anastomosis using the overlap method were performed for the esophageal stricture due to rupture during endoscopic balloon dilatation. The patient’s postoperative recovery was unremarkable, and the dysphagia due to esophageal stricture disappeared.

The overlap technique in esophago-jejunal anastomosis after partial esophagectomy was very effective for an esophageal stricture in a patient with achalasia because it made possible the additional resection of endoluminal muscle.

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