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ACHALASIA IN CHILDREN BABIES KIDS
Category: Pediatric Surgery
Abstract : achalasia in children babies kids : Achalasia in children is an uncommon
esophageal motor disorder distinguished by clinical, radiological and
manometrics features. Incidence is estimated in 0.1 cases/year per 100,000
population under 14 years of age. Clinical presentation is characterized by
progressive dysphagia, regurgitation, weight loss, chest pain and nocturnal
cough. Infants exhib
achalasia in children babies kids : Achalasia in children is an uncommon
esophageal motor disorder distinguished by clinical, radiological and
manometrics features. Incidence is estimated in 0.1 cases/year per 100,000
population under 14 years of age. Clinical presentation is characterized by
progressive dysphagia, regurgitation, weight loss, chest pain and nocturnal
cough. Infants exhibit failure to thrive.
Diagnosis is established by barium
swallow and confirmed by manometry and motility studies.
Ba swallow
shows' esophageal dilatation, motility alteration and a small caliber
(bird-beak) cardio-esophageal junction. Manometry reveals elevated E-G sphincter
pressure, non- peristaltic esophageal contraction and failed relaxation of lower
esophageal sphincter upon swallowing.
Videofluoroscopy can be of help in
the screening of esophageal motors disorders. Esophageal pneumatic balloon
dilatation is not an effective method of treatment in children due to the high
rate of recurrence of symptoms.
achalasia in children babies kids :
Primary therapy is surgical (Heller's modified esophagomyotomy), and results are
similar after a transabdominal or thoracic approach. Many authors favor a
concomitant antireflux procedures in these patients. Nifedipine can be of help
as a short management in preparation for surgery. Long-term result presents' a
connection between achalasia and malignant disease of the esophagus.
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