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Congenital cricopharyngeal achalasia treatment by dilatations
Insights
Cricopharyngeal achalasia in infants can be successfully treated with muscle dilatations. This approach led to normal feeding, weight gain, and resolution of aspiration pneumonia in one infant.
Area of Science:
- Pediatric Gastroenterology
- Otolaryngology
Background:
- Cricopharyngeal achalasia is a rare condition affecting infants, leading to feeding difficulties.
- Recurrent aspiration pneumonia and failure to thrive are significant complications.
Observation:
- An infant presented with severe failure to thrive, recurrent aspiration pneumonia, and diagnosed cricopharyngeal achalasia.
- The infant was managed with nasogastric tube feeding for five months.
Findings:
- Prompt response to dilatations of the spastic cricopharyngeal muscle was observed.
- Following treatment, the infant achieved normal oral feeding, progressive weight gain, and no further pulmonary issues.
Implications:
- Cricopharyngeal muscle dilatations offer a viable treatment for infant cricopharyngeal achalasia.
- This minimally invasive approach can prevent long-term complications like failure to thrive and aspiration pneumonia.
Abstract:
An infant with cricopharyngeal achalasia, recurrent aspiration pneumonia, and severe failure to thrive was fed for 5 months through a nasogastric tube. She responded promptly to dilatations of the spastic cricopharyngeal muscle. Normal oral feedings followed the treatment with progressive weight gain and no further pulmonary complications over a follow-up period of 1 1/2 years. Dilatations were used in the infant described here, in analogy to the well-known success of treatment by dilatations in infants with achalasia of the lower esophagus.