Acalasia en obesos mórbidos: reporte de casos / Achalasia in morbidly obese patients: report of two cases

ABSTRACT

Achalasia is uncommon in morbidly obese patients. We report two patients with both conditions. A 71 years old diabetic male with a body mass Índex (BMI) of 36 kg/m . He consulted for dysphagia and a manometry showed a lack of relaxation of the lower esophageal sphincter. He was subjected to unsuccessful pneumatic dilatations in two occasions. Finally the patient was subjected to a total gastrectomy and Roux en Y esophago-jejunal anastomosis. Eight months after surgery the patient reports slight dysphagia and lost 24 kg. A 66 years old male with a BMI of 44 kg/m² consulting for regurgitation. Manometry confirmed the diagnosis of achalasia. The patient was subjected to a esophagomyotomy, subtotal gastrectomy and Roux en Y gastro jejunal and jejuno-jejunal anastomosis. Two years after surgery the patient had a slight dysphagia and lost 20 kg.

RESUMEN

La acalasia es un trastorno de la motilidad esofágica que tiende a producir baja de peso, siendo rara su presentación en obesos mórbidos. Existen pocos reportes de casos en la literatura. Se presentan 2 casos de pacientes con el diagnóstico de acalasia y obesidad mórbida, uno de ellos tratado con Gastrectomía total y el otro con Esofagomiotomía asociada a Bypass gástrico. Ambos pacientes evolucionaron en buenas condiciones. Finalmente se realiza un análisis de la literatura.