Delhi hospital claims world’s first double obstruction in food pipe successfully treated

A team of doctors at Sir Ganga Ram Hospital has led world’s first endoscopic procedure to treat a complex case of double obstruction in the food pipe, successfully addressing two diseases of the food pipe in a patient with advanced chronic liver disease.

The patient, a 45-year-old male from Shimla, Himachal Pradesh, had been suffering from chronic liver disease (cirrhosis), a condition where the liver shrinks over time, leading to severe complications and large development of large tortuous blood vessels called esophageal varices at junction of food pipe and stomach with a potential to cause massive bleeding from mouth.

In addition to cirrhosis, the patient presented with two other critical diseases affecting the food pipe: achalasia cardia and a large lower out pouching of lower food pipe called oesophageal diverticulum.

Achalasia cardia is a disorder that impedes the proper swallowing of food due to a tight lower oesophageal sphincter, which fails to relax during swallowing which results in food getting stuck up in the chest and the resultant stasis was leading to recurrent vomiting, regurgitation, and pneumonia due to stagnation of food both   in the lower esophagus and its out pouching called esophageal diverticula.

Dr. Anil Arora, Chairman and Head of the Department of Gastroenterology at Sir Ganga Ram Hospital, led the complex surgery. Dr. Shivam Khare, Consultant at the Department of Gastroenterology, said “There were two main options for treatment: surgery, which is extremely risky in such cases, or endoscopy. However, the presence of swollen dilated veins at gastro esophageal junction made endoscopic treatment even more challenging. This case was particularly complicated because we needed to treat both achalasia cardia and the diverticulum while also ensuring that we avoided bleeding from the prominent dilated veins at gastro oesophagus junction,”

Dr Arora said this successful treatment is a remarkable achievement, not only for its complexity but also for the novel approach we employed. The patient, who had previously struggled with swallowing, is now able to consume a normal diet and has a new lease on life within a span of week after our innovative treatment.