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[Diagnosis and treatment of esophageal achalasia in children]
Insights
Pediatric achalasia treatment should start with pneumatic dilation. Modified Heller
Area of Science:
- Pediatric Gastroenterology
- Esophageal Motility Disorders
Background:
- Achalasia is a rare esophageal motility disorder affecting children.
- Accurate diagnosis and effective treatment are crucial for pediatric patients.
Purpose of the Study:
- To report the diagnostic and therapeutic outcomes for pediatric achalasia.
- To evaluate different treatment modalities in children.
Main Methods:
- Radiological examination with nitroglycerin test for diagnosis.
- Endoscopic and esophagomanometric evaluations for esophageal assessment.
- Analysis of outcomes for drug therapy, surgery, and pneumatic dilation.
Main Results:
- Radiological examination with nitroglycerin test was highly informative.
- Pneumatic dilation is recommended as the initial treatment.
- Modified Heller's operation with fundoplication yielded good results.
Conclusions:
- Early pneumatic dilation is the preferred initial treatment for pediatric achalasia.
- Surgical intervention, specifically modified Heller's operation, is effective for refractory cases.
Abstract:
The article shows the results of diagnosis and treatment of achalasia of the esophagus in 21 children aged from 20 months to 15 years. Radiological examination with the use of the nitroglycerin test was highly informative and authentic in all cases. To evaluate the condition of the esophagus, additional endoscopic and esophagomanometric examination is necessary. From analysis of the results of drug therapy in all patients, operative in 13, and pneumocardiodilatation in 7 children it was found that treatment of achalasia of the esophagus in children should begin with forced pneumodilatation. Modified Heller's operation with fundoplication produces good results.