A successful endoscopic procedure was performed on a 67-year-old man who had been experiencing dysphagia for the past 15 years. The expert medical team at KIMSHEALTH successfully treated his condition of nutcracker esophagus, an esophageal disorder, through Peroral Endoscopic Myotomy (POEM). The patient had been surviving on liquid food for the past 15 years.
The patient, a resident of Thiruvananthapuram, sought treatment at the Gastroenterology Department due to difficulty in swallowing food and experiencing continuous vomiting. Recognizing the severity of the symptoms, the medical team at KIMSHEALTH promptly conducted an endoscopy, which revealed the presence of an impacted food bolus in the lower esophagus, masquerading as a tumour. The bolus was removed using an endoscope, and the condition was later confirmed to be Nutcracker esophagus in a detailed esophageal manometry test. This rare condition causes the muscles in the esophagus to contract strongly, resembling a nutcracker, which leads to difficulties in swallowing food. During attempts to eat, the muscles contract forcefully, obstructing the passage of ingested food to the stomach.
The medical team led by Dr. Madhu Sasidharan, Senior Consultant, Department of Gastroenterology successfully carried out the POEM procedure using advanced endoscopic technology. The procedure involved inserting a flexible endoscopic tube through the mouth and creating a minor incision in the esophagus to cut and relax the lower esophageal muscles for a length of about 10 cm. The incision was then closed using clips, providing immediate relief to the patient.
Post-procedure, the patient was completely free of dysphagia and regained the ability to swallow unhindered. POEM is the ideal option for this clinical condition, whereas surgical myotomy is not in any way helpful in treating this condition, opined Dr. Madhu Sasidharan. Dr. Ajith K. Nair, Dr. Harish Kareem, Senior Consultants, and Dr. Arun P, Associate Consultant, Department of Gastroenterology, along with Anesthetist Dr. Rajat Roy, were also part of this procedure.