Achalasia Cardia in a Young Infant

Poornachand, V.; Kumarasamy, K; Karamath, S. P.; Seenivasan, V.; Bavanandam, Sumathi; Dheivamani, Nirmala

doi:10.1007/s12098-018-2610-7

Cited by 3 publications

(11 citation statements)

References 11 publications

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“…Poornachand states that the median time from symptoms onset to diagnosis is nearly 3 years [1]. The patient᾿s age and the rarity of achalasia in pediatric population are the reasons that our patient᾿s condition was considered as distal esophageal peptic stenosis due to GER and treated by antiulcer therapy.…”

Section: Discussionmentioning

confidence: 98%

“…Overall, the most presenting symptoms are regurgitation (83%), dysphagia (71%), poor growth (54%) and respiratory symptoms (41%) [7]. The diagnosis of achalasia is difficult to establish in children under 5 years of age, since it᾿s incidence is very low, and often there is a delay in making the diagnosis and applying the appropriate treatment [1]. Although 18% of pediatric patients have symptom onset during infancy, in only 6% of patients the diagnosis of achalasia is established during infancy [7].…”

Section: Discussionmentioning

confidence: 99%

“…Esophageal achalasia is a neurodegenerative motility disorder of the esophagus, characterized by ineffective esophageal peristalsis and the absence of relaxation of hypertonic lower esophageal sphincter (LES), due to degenerative changes of inhibitory fibers and ganglion cells of esophageal Auerbach myenteric plexus [1,2]. The clinical symptoms of achalasia were first described by Thomas Willis in 1674.…”

Section: Introductionmentioning

confidence: 99%

“…The incidence of achalasia is 1:100.000 people, with symptoms mainly occurring in adolescents and adults between the ages of 30 and 60 [1,4,5]. Only 3 to 5% of patients are younger than 14 years, and the disease is extremely rare in infancy [5].…”

Section: Introductionmentioning

confidence: 99%

“…However, a case of premature infant weighing 1200 gr with achalasia is reported [5]. Some authors found the annual incidence of achalasia in children 0.11:100.000, mostly between the ages of 7 and 12 [1]. Ahalasia can be a primary congenital disorder, a consequence of some infectious diseases (Chagas disease, varicella and viral esophagitis), or autoimmune diseases (Guillian-Barre acute polyradiculoneuritis, Sjögren syndrome, eosinophilic esophagitis and scleroderma) [2].…”

Section: Introductionmentioning

confidence: 99%

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Esophageal achalasia in a two-year-old boy

et al. 2020

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Introduction. Esophageal achalasia is a neurodegenerative motility disorder, which is characterized by ineffective or absent esophageal peristalsis and the lack of hypertonic lower esophageal sphincter relaxation. Achalasia causes failure to thrive in children and can have serious respiratory complications. Achalasia is a very rare condition in pediatric population, and usually misdiagnosed as gastroesophageal reflux. The treatment of choice is Heller esophagocardio-myotomy. The aim of this paper is to present a rare case of a two-year-old child with achalasia, diagnostic procedures, and successful operative treatment. Case outline. The patient?s problems started at the age of six months, with audible breathing and respiratory stridor. The child was admitted at a local hospital at seven months of age, dismissed with dietary advices, again admitted at the age of 19 months, and transferred to our institution. Upper gastrointestinal series and computed tomography revealed findings characteristic for achalasia, and on esophagoscopic exam there was no opening of lower esophageal sphincter and cardia on insufflation. Pneumatic dilation was performed with temporary improvement. Laparotomic Heller esophagocardiomyotomy with Dor partial fundoplication was successfully performed. Conclusion. Achalasia is a very rare condition in infants and small children. There is often a delay in establishing the correct diagnosis. Upper gastrointestinal series and endoscopic exam are most reliable methods to detect achalasia. Pharmacological treatment, intrasphincteric injection of botulinum toxin and pneumatic dilations are not efficient methods, especially in small children. The method of choice in the treatment of achalasia is Heller esophagocardiomyotomy with partial fundoplication.

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Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Esophageal achalasia in a two-year-old boy

et al. 2020

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Neonatal Achalasia Cardia: A Case Report

Nelakurthi,

Bheemireddy

2024

Cureus

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Achalasia cardia is more common in adults between the ages of 30 and 60 years. It is relatively uncommon in children and very rare in infants. Only a few cases of infants with achalasia have been reported till now. It is a motility disorder of the esophagus due to a failure to relax the lower esophageal sphincter. The common clinical presentations in infants are regurgitation, vomiting, respiratory symptoms, and failure to thrive. This can be easily misdiagnosed as gastroesophageal reflux disease. Surgical management is the mainstay of treatment. Here, we present the case of a female newborn with symptoms suggestive of achalasia from day one of life and successfully treated with Heller’s esophagocardiomyotomy and Nissen’s fundoplication, following which the baby is asymptomatic and thriving well.

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Achalasia in an Eight-Week-Old Infant Successfully Managed by CRE Balloon Dilatation: A Case Report and Literature Review

Alsarhan,

Hamdi,

Golightly

et al. 2024

Cureus

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Achalasia is uncommon in pediatrics and typically presents after five years of age. It is often managed medically, endoscopically, or surgically such as myectomy. This case highlights an exceptionally rare occurrence of achalasia at the age of eight weeks, successfully treated with endoscopic CRE® balloon dilatation, providing prompt relief of symptoms. From birth, this full-term infant experienced persistent vomiting and choking, coupled with suboptimal weight gain and unresponsiveness to anti-reflux measures. Diagnostic assessments revealed notable findings a barium meal demonstrated contrast pooling in the esophagus with distal rat tail narrowing, and esophageal manometry identified elevated pressure at the lower esophageal sphincter (LES) and inadequate esophageal contractions consistent with the diagnosis of achalasia. The infant underwent two sessions of esophageal CRE® balloon dilatation under fluoroscopy 10 days apart. Possible associated syndromes were ruled out. No further interventions were needed for a follow-up duration of one year. The literature review reveals several modalities for treating achalasia in adults and older children, but there is a scarcity of data on younger children and infants. In this article, we reviewed current available evidence regarding treatment modalities and the success rate. There is an obvious lack of recommendations for children, particularly at younger ages, and the outcome is various given the rarity of this condition and the limited experience.

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Achalasia Cardia in a Young Infant

Cited by 3 publications

References 11 publications

Esophageal achalasia in a two-year-old boy

Esophageal achalasia in a two-year-old boy

Neonatal Achalasia Cardia: A Case Report

Achalasia in an Eight-Week-Old Infant Successfully Managed by CRE Balloon Dilatation: A Case Report and Literature Review

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