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[Achalasia in children].

P Torres1, G Gómez, C Tfejo

  • 1Servicio de Gastroenterología del Hospital de Niños J. M. de los Ríos, Caracas, Venezuela.

G.E.N
|October 1, 1990
PubMed
Summary
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Childhood achalasia, a rare esophageal motility disorder, presents with progressive dysphagia and weight loss. Mechanical disruption of the lower esophageal sphincter improved symptoms and sphincter pressure.

Area of Science:

  • Pediatric Gastroenterology
  • Esophageal Motility Disorders

Background:

  • Achalasia is a rare esophageal motility disorder with a long history, infrequently diagnosed in pediatric populations.
  • This study examines four pediatric cases of achalasia diagnosed and treated at J. M. de los Ríos Hospital between 1971 and 1990.

Observation:

  • Pediatric achalasia cases presented with progressive dysphagia (difficulty swallowing) for solids and liquids, regurgitation, weight loss, and nocturnal cough.
  • Diagnostic evaluations included radiological, endoscopic, and manometric studies revealing esophageal dilation, altered motility, a narrow cardio-esophageal junction, elevated lower esophageal sphincter pressure, and non-peristaltic contractions.

Findings:

  • The Starck dilator was employed for mechanical disruption of the lower esophageal sphincter muscle fibers.
  • This intervention resulted in significant improvement of clinical symptoms and a reduction in elevated lower esophageal sphincter pressure.

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Implications:

  • Mechanical disruption of the lower esophageal sphincter offers a viable treatment for pediatric achalasia.
  • The procedure facilitated adequate weight gain (pondostatural progress) and a satisfactory clinical outcome in the studied pediatric patients.