Bridging therapy for achalasia in a second trimester pregnant patient.
case_report · Level V
Where this comes from
- Record sourced from PubMed, PMID 30911523.
- Also identified by DOI 10.4103/jfmpc.jfmpc_389_18 and PMC identifier 6396631.
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Abstract
We present the case of a 28-year-old female who presented for primary care at 22-week gestation with type II achalasia and worsening solid/liquid dysphagia leading to pregnancy weight loss. Considering that durable therapies such as surgical myotomy and pneumatic dilatation have considerable risk, botulinum A toxin injection was selected as a temporizing bridging therapy. She had an uncomplicated post procedure course and had significant rapid improvement in dysphagia symptoms, which enabled her to progress to normal peripartum weight. This case highlights the need for early recognition of achalasia and an unique niche for use of botulinum toxin A as a temporizing therapy in this risk averse population.