Publication: First Successful Independent Peroral Endoscopic Myotomy (POEM) for Achalasia Cardia: A Milestone Case Report from Nepal
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Date
2025
Journal Title
Journal ISSN
Volume Title
Publisher
Kathmandu University
Abstract
ABSTRACT
Achalasia cardia is an uncommon esophageal motility disorder characterized by
failure of relaxation of the lower esophageal sphincter and loss of peristalsis in the
lower part of the esophagus. Peroral Endoscopic Myotomy (POEM) has emerged
as a minimally invasive intervention equivalent to Heller myotomy and an effective
treatment modality. We present the first successful solo peroral endoscopic
myotomy procedure performed in Nepal by an interventional gastroenterologist,
who has managed a 45-year-old patient with long-standing dysphagia and a history
of failed pneumatic dilatation with success. The procedure was uneventful. The
patient showed symptomatic improvement postoperatively with minimal reflux.
This case highlights the feasibility and safety of independently performed peroral
endoscopic myotomy in a resource-limited setting. It shows the diaspora of
interventional gastroenterology in Nepal and begins a new era for the same.
KEY WORDS
Achalasia cardia, Dysphagia, Eckardt score, Peroral endoscopic myotomy (POEM)
Description
Purbey BK,1 Karki S,1 Khanal A,2 Khadka D,2 Singla V,3 Adhikari S4
1Department of Gastroenterology
HAMS Hospital, Mandikhatar, Kathmandu, Nepal
2Department of Gastroenterology
NAMS, Bir Hospital, Kathmandu, Nepal
3Department of Gastroenterology
MAX Hospital, New Delhi, India
4Department of Internal Medicine
HAMS Hospital, Mandikhatar, Kathmandu, Nepal
Keywords
Achalasia cardia, Dysphagia, Eckardt score, Peroral endoscopic myotomy (POEM)