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Clinical and ultrasound approach to achalasia in a child. Case report

Daniela Iacob1, Otilia Fufezan, Dorin Farcau

  • 1University of Medicine and Pharmacy Iuliu Haţieganu, Department of Anaesthesia, 3rd Pediatric Clinic, str. Campeni nr.2-4, Cluj-Napoca, Romania. iacobdaniela777@gmail.com

Medical Ultrasonography
|December 18, 2010
PubMed

Insights

This case study highlights how abdominal ultrasound aided in diagnosing pediatric achalasia, a rare esophageal disorder, misdiagnosed initially as asthma. Early diagnosis and surgical intervention led to successful patient outcomes.

Area of Science:

  • Pediatric Gastroenterology
  • Esophageal Motility Disorders
  • Diagnostic Imaging

Background:

  • Achalasia is a primary esophageal motor disorder marked by impaired lower esophageal sphincter (LES) relaxation.
  • Unknown etiology contributes to the challenge in diagnosing achalasia, particularly in pediatric cases.
  • Misdiagnosis can delay appropriate treatment, impacting patient prognosis.

Observation:

  • A child initially diagnosed with asthma showed no improvement with standard treatments.
  • Symptoms of dysphagia, food regurgitation, and weight loss prompted further investigation.
  • Abdominal ultrasound revealed significant esophageal dilation and distal narrowing, suggesting achalasia.

Findings:

  • Ultrasound served as a pivotal diagnostic tool, redirecting the clinical suspicion from asthma to achalasia.
  • Barium swallow, upper digestive endoscopy, and esophageal manometry confirmed the achalasia diagnosis.
  • The diagnostic process underscores the importance of considering rare conditions in treatment-resistant cases.

Implications:

  • This case demonstrates the utility of ultrasound in diagnosing pediatric achalasia, especially when initial symptoms are atypical.
  • Prompt and accurate diagnosis is crucial for effective management of esophageal motility disorders.
  • Surgical intervention, such as esocardiomiotomy with antireflux technique, can yield excellent results in pediatric achalasia.

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