Patient's food pipe was jammed, blood used to come out of the mouth, now new life after treatment
The food pipe is an important means of getting nutrition in our body, if there is any kind of blockage in it, then all the problems can arise.
Double Obstruction in Food Pipe: If there is a blockage in the food pipe of any person, then it becomes difficult for him to eat and drink, although in the current era, endoscopy technology has progressed so much that doctors are able to treat very difficult medical conditions. Something similar happened with a chronic liver disease patient who has got a new life.
Renowned gastroenterologist Dr. Anil Arora said that he removed the double blockage in the food pipe of a patient with chronic liver disease through an endoscopic procedure. A 45-year-old patient living in Shimla, Himachal Pradesh, who was suffering from cirrhosis, had a shrinking liver, which caused a lot of trouble. This leads to the development of a large tortillus blood vessel, also known as oesophageal warsi, which occurs at the junction between the food pipe and the oesophagus, which causes bleeding from the mouth.
In addition to
cirrhosis, the patient had two other major diseases affecting the food pipe: Achalasia cardia and a large lower outpouring of the lower food pipe called the oesophageal diverticulum. Akalasia cardia is a disorder that prevents proper swallowing of food due to a tight lower esophageal sphincter, which fails to relax during swallowing, after which food gets stuck in the chest and causes recurrent vomiting, flatulence, and pneumonia. The stagnation of food in both the lower oesophagus and its outpoaching is called esophageal diverticula.
Also, the patient had oesophageal varix, which is a common condition in cirrhosis, where enlarged veins in the food pipe can be life-threatening as it leads to bleeding. Despite undergoing medical treatment for varisis, the patient's complex condition presented major challenges.
What did the doctor say?
Dr. Shivam Khare, Consultant, Department of Gastroenterology, Sir Ganga Ram Hospital, spoke about the difficulties of treating such a case. "There were two main options for treatment: surgery, which is extremely risky in such cases, or endoscopy. However, the presence of swollen dilated veins at the gastroesophageal junction made endoscopic treatment more challenging. The case was particularly complicated because we needed to treat both the akalasia cardia and the diverticulum, as well as make sure we avoided bleeding from major dilated veins, especially at the gastroesophagous junction," he said.
The medical team, in collaboration with radiologists Dr Arun Gupta, Dr Ajit Yadav and Dr Raghav Seth, devised a meticulous treatment plan. The next step was a combined paroral endoscopic myotomy (POM) procedure, which simultaneously addressed both akalasia cardia and diverticulum.
Dr. Anil Arora explained that the POEM procedure is a minimally invasive endoscopic treatment that involves four major steps: mucosal entry, formation of a submucosal tunnel, myotomy of the diverticulum (cutting the oesophageal muscle), and myotomy of the lower esophageal sphincter (LES) for akalasia cardia. During the procedure, special care was taken to freeze and fluff up any exposed varices, preventing bleeding during treatment.
Dr. Anil Arora said, "This successful treatment is a remarkable achievement not only for its complexity but also for the new approach we have adopted. The patient who was earlier struggling with swallowing is now able to consume a normal diet and has a new dimension in life within a week of our innovative treatment.
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