Retrospective analysis of paediatric achalasia in India: Single centre experience

Singh, Sunita; Wakhlu, Ashish; Pandey, Anand; Kureel, Shiv Narain; Rawat, Jiledar

doi:10.4103/0189-6725.99396

Cited by 8 publications

(17 citation statements)

References 30 publications

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“…[ 13 ] The mean age at surgery in our study was consistent with other pediatric studies such as Erginel et al , Lee et al , Hallal et al , Corda et al , Karnak et al , Singh et al , Smits et al , Zagory et al , and Saliakellis et al as they reported mean age at surgery of 3.34 years, 13 ± 6 years, 11 years, 12 years, 8.3 years, 3.25 ± 0.4 years, 11.4 ± 3.4 years, 11.6 ± 5 years, and 10 years, respectively. [ 2 7 14 15 16 17 18 19 20 ] There was no gender predilection in adult studies while the pediatric studies showed a male preponderance. [ 2 3 7 14 15 16 17 18 19 20 ] However, our study showed a female preponderance (9:3).…”

Section: Discussionmentioning

confidence: 99%

Evaluation and Management of Achalasia Cardia in Children

Kumar,

Gadgade,

Shivapur

et al. 2023

Journal of Indian Association of Pediatric Surgeons

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A BSTRACT Background: Achalasia cardia is a neuromuscular disorder of unknown etiology characterized by aperistalsis of the body of the esophagus and failure of relaxation of the lower esophageal sphincter. The diagnosis of achalasia cardia is delayed due to the rarity and the ability to mimic other common conditions in children. Hence, a study was conducted to evaluate the clinical presentation and the management of achalasia cardia in children. Materials and Methods: A retrospective observational study was conducted in the department of pediatric surgery at a tertiary center. The children with achalasia cardia who presented between January 2014 and December 2021 were included. Results: A total of 12 patients were treated for achalasia cardia during the study period. All children presented with recurrent episodes of vomiting, whereas dysphagia was seen in six (50%) children. Eighty-three percent of the children presented with a history of weight loss, whereas failure to thrive was seen in nine (75%) children. Five (42%) children were managed as gastroesophageal reflux disease (GERD) for more than a year before presenting to us. Three (25%) children underwent open cardiomyotomy with Thal fundoplication and the rest nine (75%) underwent laparoscopic cardiomyotomy. All are thriving well. Conclusion: Achalasia is an important differential diagnosis in children with suspected GERD. The most common symptom of achalasia cardia is vomiting followed by dysphagia. Weight loss and failure to thrive are important presenting features in children with achalasia which are uncommon in adults. Cardiomyotomy without fundoplication is safe and effective to treat achalasia cardia in children without having any extra complications.

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Section: Discussionmentioning

confidence: 99%

Evaluation and Management of Achalasia Cardia in Children

Kumar,

Gadgade,

Shivapur

et al. 2023

Journal of Indian Association of Pediatric Surgeons

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“…It is a chronic but benign disease of an unknown etiology and is a common cause of dysphagia ( 3 ). The most common symptoms of Achalasia are regurgitation, vomiting, dysphagia, cough, recurrent pneumonia, and poor weight gain or weight loss ( 1 , 2 , 4 ). The “bird’s beak” appearance of the lower esophagus on the esophagogram (barium swallow) is a classical radiological finding in the cases of esophageal Achalasia ( 1 , 2 , 4 ).…”

Section: Introductionmentioning

confidence: 99%

“…The most common symptoms of Achalasia are regurgitation, vomiting, dysphagia, cough, recurrent pneumonia, and poor weight gain or weight loss ( 1 , 2 , 4 ). The “bird’s beak” appearance of the lower esophagus on the esophagogram (barium swallow) is a classical radiological finding in the cases of esophageal Achalasia ( 1 , 2 , 4 ). Achalasia is rare in children, with an estimated annual incidence of only 0.02–0.11 cases per 100 000 children, and it is more infrequent in the below 5-year age group ( 1 , 2 , 4 ).…”

Section: Introductionmentioning

confidence: 99%

“…The “bird’s beak” appearance of the lower esophagus on the esophagogram (barium swallow) is a classical radiological finding in the cases of esophageal Achalasia ( 1 , 2 , 4 ). Achalasia is rare in children, with an estimated annual incidence of only 0.02–0.11 cases per 100 000 children, and it is more infrequent in the below 5-year age group ( 1 , 2 , 4 ). The goal of treating achalasia cardia is the relief of the functional obstruction at the level of the gastroesophageal junction ( 3 ).…”

Section: Introductionmentioning

confidence: 99%

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An 18-Month-Old Child Suffering From Achalasia Cardia Successfully Treated With Pneumatic Dilation

Rashid

Arfin²,

Alam³

2022

JPGN Reports

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Achalasia cardia is an idiopathic esophageal motility disorder. It is rare in children and infrequent in below school-going age groups. The “bird’s beak” appearance of the lower esophagus on the esophagogram (barium swallow) is a classical radiological finding in the cases of esophageal Achalasia. The goals of achalasia therapy are symptom relief and improvement of esophageal emptying to prevent megaesophagus. The most effective treatment options are pneumatic dilation and surgical myotomy (Heller’s myotomy). Pneumatic dilation is the initial treatment of choice and does not preclude myotomy. Here, we present our experience with a young child with achalasia cardia that was successfully treated with pneumatic dilation.

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“…The overall incidence of achalasia is 1.63 : 100 000, fewer than 5% of whom are children [4, 5]. However, young age at presentation is an independent predictive factor of failure of conservative treatment [6].…”

Section: Introductionmentioning

confidence: 99%

Pediatric achalasia. Single-center study of interventional treatment

Grabowski

Korlacki

Pasierbek

et al. 2017

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IntroductionEsophageal achalasia is a rare entity in children. However, young age is a factor of failure of conservative treatment, emphasizing the role of surgery. In our institution laparoscopic Heller’s cardiomyotomy is the chosen procedure for surgical treatment.AimTo assess the outcome of surgery for achalasia treatment in children operated on in a single institution.Material and methodsA retrospective analysis of consecutive patient records from the years 1997 to 2014 was performed. There were 11 patients. Their mean age was 13 years, ranging from 6 to 17. Duration of symptoms was 2 to 36 months, mean 16. All 11 patients were operated on with a laparoscopic approach. Pneumatic dilatation was used both pre- and postoperatively but in no case was sufficient on its own. Collected data included patient demographics, preoperative symptoms and their duration, diagnostic findings and therapeutic means. Surgical procedures, complications and long-term follow-up were analyzed. The follow-up lasted from 1 to 10 years and finished when the patient reached 18 years of age.ResultsTwelve laparoscopic cardiomyotomies were performed with concomitant fundoplications, 10 Toupet and 2 Dor and one redo procedure. There were no deaths. Two perforations were repaired promptly. The success rate was 82%, though with subsequent dilatations. One failure was due to serious progression of the disease.ConclusionsIn our opinion, laparoscopic Heller’s myotomy is the procedure of choice for treating achalasia in children. Endoscopic balloon dilatation may be used as a complementary treatment, especially as a primary redo procedure.

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Retrospective analysis of paediatric achalasia in India: Single centre experience

Abstract: Cardiomyotomy with partial fundoplication is the best modality of treatment for paediatric achalasia cardia, even from parents' perspective.

Cited by 8 publications

References 30 publications

Evaluation and Management of Achalasia Cardia in Children

Evaluation and Management of Achalasia Cardia in Children

An 18-Month-Old Child Suffering From Achalasia Cardia Successfully Treated With Pneumatic Dilation

Pediatric achalasia. Single-center study of interventional treatment

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