{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2023,10,6]],"date-time":"2023-10-06T11:21:41Z","timestamp":1696591301793},"reference-count":7,"publisher":"Hindawi Limited","license":[{"start":{"date-parts":[[2012,1,1]],"date-time":"2012-01-01T00:00:00Z","timestamp":1325376000000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/3.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Case Reports in Surgery"],"published-print":{"date-parts":[[2012]]},"abstract":"<jats:p><jats:italic>Background<\/jats:italic>. Achalasia may lead to cachexia if not diagnosed in an early stage. Surgery in cachectic patients is hazardous and complications may result in a protracted recovery or even death. Different treatment options have been described. In this paper, we report a stepwise surgical laparoscopic approach which appears to be safe and effective.<jats:italic>Methods<\/jats:italic>. Over a one-year period, a patient with a body mass index (BMI) below 17 being treated for anorexia nervosa was referred with dysphagia. Because of the extreme cachexia, a laparoscopic feeding jejunostomy (LFJ) was fashioned to enable long-term home enteral feeding. The patient underwent a laparoscopic Heller myotomy (LHM) when the BMI was normal.<jats:italic>Results<\/jats:italic>. The patient recovered well following this stepwise approach.<jats:italic>Conclusion<\/jats:italic>. Patients with advanced achalasia usually present with extreme weight loss. In this small group of patients, a period of home enteral nutrition (HEN) via a laparoscopically placed feeding jejunostomy allows weight gain prior to safe definitive surgery.<\/jats:p>","DOI":"10.1155\/2012\/985454","type":"journal-article","created":{"date-parts":[[2012,10,4]],"date-time":"2012-10-04T17:05:24Z","timestamp":1349370324000},"page":"1-2","source":"Crossref","is-referenced-by-count":2,"title":["Extreme Achalasia Presenting as Anorexia Nervosa"],"prefix":"10.1155","volume":"2012","author":[{"given":"P. J.","family":"Goldsmith","sequence":"first","affiliation":[{"name":"Division of Surgery, Stepping Hill Hospital, Poplar Gove, Hazel Grove, Stockport SK2 7JE, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"B.","family":"Decadt","sequence":"additional","affiliation":[{"name":"Division of Surgery, Stepping Hill Hospital, Poplar Gove, Hazel Grove, Stockport SK2 7JE, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"98","reference":[{"issue":"10","key":"1","doi-asserted-by":"crossref","first-page":"1120","DOI":"10.1136\/gut.27.10.1120","volume":"27","year":"1986","journal-title":"Gut"},{"issue":"4","key":"2","doi-asserted-by":"crossref","first-page":"216","DOI":"10.1007\/BF02412690","volume":"5","year":"1990","journal-title":"Dysphagia"},{"key":"3","doi-asserted-by":"publisher","DOI":"10.1097\/01.yco.0000228759.95237.78"},{"key":"4","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2982.2010.01511.x"},{"issue":"6844","key":"5","doi-asserted-by":"crossref","first-page":"43","DOI":"10.1136\/bmj.305.6844.43","volume":"305","year":"1992","journal-title":"British Medical Journal"},{"key":"6","doi-asserted-by":"publisher","DOI":"10.1016\/j.suc.2005.01.002"},{"issue":"46","key":"7","first-page":"1002","volume":"49","year":"2002","journal-title":"Hepato-Gastroenterology"}],"container-title":["Case Reports in Surgery"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/downloads.hindawi.com\/journals\/cris\/2012\/985454.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/downloads.hindawi.com\/journals\/cris\/2012\/985454.xml","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/downloads.hindawi.com\/journals\/cris\/2012\/985454.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2017,6,20]],"date-time":"2017-06-20T21:01:17Z","timestamp":1497992477000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.hindawi.com\/journals\/cris\/2012\/985454\/"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2012]]},"references-count":7,"alternative-id":["985454","985454"],"URL":"https:\/\/doi.org\/10.1155\/2012\/985454","relation":{},"ISSN":["2090-6900","2090-6919"],"issn-type":[{"value":"2090-6900","type":"print"},{"value":"2090-6919","type":"electronic"}],"subject":[],"published":{"date-parts":[[2012]]}}}