Evaluation and Management of Achalasia Cardia in Children: A Retrospective Observational Study

Journal of Indian Association of Pediatric Surgeons · 5 authors, 1 centre

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TL;DR

All patients presented with recurrent vomiting; dysphagia was present in 50%, weight loss in 83%, and failure to thrive in 75%.

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All patients presented with recurrent vomiting; dysphagia was present in 50%, weight loss in 83%, and failure to thrive in 75%. One child in the laparoscopy group had food bolus impaction managed endoscopically. Limitations include the small sample size and retrospective design. The study highlights that cardiomyotomy without fundoplication is safe and effective in children.

STUDY TYPE

cohort

SPECIALTY

pediatrics

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100% · A

ORIGINAL PAPER

PMC10569275

Evaluation and Management of Achalasia Cardia in Children: A Retrospective Observational Study

Journal of Indian Association of Pediatric Surgeons

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ABSTRACT

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.

CITATION EXPORT

Nitin Kumar, Bahubali Deepak Gadgade, Achyuth Ananth Shivapur et al.. Evaluation and Management of Achalasia Cardia in Children: A Retrospective Observational Study. Journal of Indian Association of Pediatric Surgeons. (2023). https://doi.org/10.4103/jiaps.jiaps_175_22

AUTHORS

5 · 1 CENTRES

Nitin Kumar, Bahubali Deepak Gadgade, Achyuth Ananth Shivapur, Veerabhadra Radhakrishna, Raghunath Bangalore Vasudev

Department of Pediatric Surgery, Bangalore Medical College and Research Institute, Bengaluru, Karnataka, India