Esophageal achalasia in pregnancy:: A case report

A 29-year-old gravida 2, para 1 developed an exacerbation of esophageal achalasia at 27 weeks' gestation. Achalasia was first diagnosed 8 months before conception and had been treated with intrasphincteric injection of botulinum toxin. During pregnancy the patient developed progressive dysphagia and retrosternal pain and lost 4 kg weight in 3 weeks. She was treated with endoscopic pneumatic dilatation of the lower esophageal sphincter (at a pressure of up to 200 mm Hg over 6 min., compared with 250 mmHg over 15 min. in nonpregnant patients). There were no adverse events and the patient was free of complaints. At 38 weeks' gestation she was delivered of a healthy, 3240-g infant. Symptoms recurred 14 weeks after delivery and she underwent renewed dilatation (up to 330 mmHg over 15 min.). Four months later she is free of symptoms.