Heller-Pinotti surgery to treat the hipertensive lower esophageal sphincter.

In the ethiological investigation of dysphagia, a mechanical obstruction in the esophageal tube of benign or a malign origin is almost always observed. However, a motor disorder must be considered in the absence of these findings. Hypertensive lower esophageal sphincter (HLES) is a type of motor disorder characterized by high pressure in the lower esophagus sphincter (LES) presenting a value higher than 45 mm Hg, associated to normal peristalsis. Patients with this disease refer dysphagia, sometimes together with thoracic pain2,3. HLES is rare once the incidence corresponds to 0.3 to 2.7% of all the patients arriving to the esophageal motility laboratories3,11. The authors had the opportunity to attend two patients. Considering the rarity of the disease, this publication aimed at reporting the clinical and therapeutical aspects and the results of the surgical treatment using the Heller-Pinotti’s technique12.