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Esophageal achalasia of unknown etiology in infants

Vijay D Upadhyaya1, A N Gangopadhyaya, D K Gupta

  • 1Department of Pediatric Surgery, IMS, BHU, Varanasi, India. upadhyayavj@rediffmail.com

World Journal of Pediatrics : WJP
|April 12, 2008
PubMed

Insights

Achalasia cardia is rare in infants, often presenting with respiratory issues or vomiting mistaken for GER. Surgical intervention, esophagocardiomyotomy, provided significant symptom relief and weight gain in most cases.

Area of Science:

  • Pediatric Surgery
  • Gastroenterology

Background:

  • Achalasia cardia is an uncommon pediatric condition, particularly in infants.
  • Respiratory symptoms and vomiting (of uncurdled milk) are common in infantile achalasia and can be misdiagnosed as gastroesophageal reflux (GER).

Purpose of the Study:

  • To present a series of pediatric achalasia cases.
  • To highlight the diagnostic challenges and treatment outcomes in infantile achalasia.

Main Methods:

  • Retrospective analysis of 8 pediatric achalasia cases over 12 years.
  • Diagnosis confirmed by clinical examination and barium studies.
  • Surgical treatment involved esophagocardiomyotomy with an antireflux procedure via abdominal route.

Main Results:

  • Seven out of eight patients survived the surgical procedure.
  • Post-operative follow-up showed remarkable symptom relief and satisfactory weight gain.
  • One case of achalasia associated with alacrimia was noted; one infant was initially misdiagnosed with gastric volvulus.

Conclusions:

  • Esophageal achalasia is a rare pediatric disease with often indeterminate origin.
  • Achalasia cardia should be considered in the differential diagnosis of infants presenting with esophageal obstruction symptoms.
Abstract

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