The Blown-Out Myotomy and Post-POEM Dysphagia
Abstract
Per-oral endoscopic myotomy (POEM) has emerged as an effective, minimally invasive treatment option for achalasia, though post-procedural dysphagia remains a concern. Common causes include gastroesophageal reflux, inadequate myotomy, and blown-out myotomy (BOM). BOM is characterized by pseudodiverticulum formation at a prior myotomy site. Longer myotomy length is commonly associated as a risk factor for BOM formation. Management is challenging, and endosurgical interventions are emerging, including per-oral plicaiton of the esophagus (POPE). Minimizing myotomy length during POEM may help reduce BOM rates. In this review, we discuss an approach to post-POEM dysphagia, with highlights on BOM from diagnosis to management.
Fields of Study & Subjects
Gastroesophageal reflux and treatments
Dysphagia Assessment and Management
Gastrointestinal motility and disorders
Publication details
- Journal / source
- Foregut The Journal of the American Foregut Society
- Publisher
- SAGE Publications
- Volume
- 6
- Issue
- 3
- Pages
- 275–281
- Publication date
- 3 July 2026
- Language
- EN