[Esophageal perforation caused by balloon dilatations in a patient with achalasia].
OBJECTIVE
To present a case of esophagic perforation due to a pneumatic dilatations of the cardias in a patient with achalasia.


BACKGROUND
Achalasia of the esophagus is a primary motor alteration with an unknown cause. The principal characteristics are the lower or absent peristaltic waves in the esophagic body and the impared lower esophagic sphincter relaxation during deglution. The management is palliative with pneumatic dilatations, pharmacologic therapy or with surgery. When a esophagic perforation occurs, it must be diagnosed and treated as soon as possible because a delay in diagnosis and management affect directly the patient prognosis.


METHODS
To present a case of esophagic perforation due to pneumatic dilatations of the cardias in a patient with achalasia.


CONCLUSIONS
An useful palliative management for achalasia is the pneumatic forceful dilatation, however it carries some risk of perforation; in every patient who was treated with dilatations is mandatory to think in perforation when the clinical condition is different after the procedure. The success of surgical management of the perforated esophagus and the control of sepsis and mediastinitis depends directly of the clinical condition of the patient and the time within perforation and surgical therapy.
de la Fuente-Lira
M
M
Servicio de Cirugía Gastrointestinal, Hospital de Especialidades Centro Médico Nacional Siglo XXI, IMSS, México, DF.
Blanco-Benavides
R
R
D000368:Aged; D002404:Catheterization / Q000009:adverse effects*; D004931:Esophageal Achalasia / Q000628:therapy*; D004939:Esophageal Perforation / Q000209:etiology*; D006801:Humans; D008297:Male