9 ± 3.6 mmHg, P = 0.001), so did LESP (LESPbefore –LESPafter = 17.1 ± 4.7 mmHg, P = 0.003) and LES residual Smad inhibitor pressure (LESRPbefore –LESRPafter = 13.2 ± 4.2 mmHg, P = 0.007). Twelve of them also finished five 5 mL viscous swallows in the supine position, and IRPviscous decreased significantly (IRPbefore –IRPafter = 14.4 ± 3.6 mmHg, P = 0.002). Some patients restored certain extent of esophageal peristalsis even still abnormal. Conclusion: POEM improved esophagogastric function by lowering patients’ IRP, LESP and
LESRP, and esophageal distension by decreasing the diameter. Long-term follow-up of larger series are needed. Key Word(s): 1. achalasia; 2. HRM; 3. esophagography; 4. POEM; Presenting Author: MIANMASHHUD AHMAD Corresponding Author: MIANMASHHUD AHMAD Affiliations: Labaid Specialized Hospital, Dhaka Bangladesh Objective: Ingestion of acid or alkali causes different grades of oesophago-gastric burn with eventual formation of stricture at different levels of upper GI tract.Intermittent bougienage dilation with or without endoprosthesis placement is the standard care management for benign oesophageal stricture. Methods: In January 2011, a 45 year old lady came to gastroenterology outpatient department of Labaid Hospital, Dhaka, Bangladesh with
dysphagia following suicidal ingestion of nearly 300 ml of floor cleaner, a strong alkali solution one month before.Ba-swallow examination revealed two >2 cm long strictures at middle and lower EMD 1214063 thirds of oesophagus.Oesophagogastro-duodenoscopy (OGD) and stricture dilation showed ulcerations and exudation over the surface of ruptured tortuous strictures.Repeated dilatation at 1–2 month intervals gave her temporary relief but have failed to maintain a satisfactory oesophageal lumen. In December 2012 a partially covered self expandable metallic Baf-A1 ic50 stent (SEM) was inserted across the strictures & kept in-situ for 6 weeks. Elective retrieval of SEM was followed by remission of her dysphagia with gradual weight gain one month after removal.Follow
up OGD in late March 2013 revealed few erythema over the previous lesion without any visible narrowing. Results: Partially covered SEMs have been recommended to palliate both benign & malignant strictures.In early 80 s there are reports of displacement &/or perforation with earlier version endoprosthesis use.Standard recommendation of repeated intermittent dilation needs frequent hospital visits for longer period with associated risk of morbimortality. On the other hand,recent series have shown long term relief of dysphagia with maintained oesophageal dilation by either biodegradable stent or SEM. Management of the present case with complex-refractory oesophageal stricture indicates that after few initial ID followed by maintenance with SEM would help maintain satisfactory lumen even long term after stent removal.