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

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 co...

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Autores principales: Kumar, Nitin, Gadgade, Bahubali Deepak, Shivapur, Achyuth Ananth, Radhakrishna, Veerabhadra, Vasudev, Raghunath Bangalore
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer - Medknow 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10569275/
https://www.ncbi.nlm.nih.gov/pubmed/37842218
http://dx.doi.org/10.4103/jiaps.jiaps_175_22
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author Kumar, Nitin
Gadgade, Bahubali Deepak
Shivapur, Achyuth Ananth
Radhakrishna, Veerabhadra
Vasudev, Raghunath Bangalore
author_facet Kumar, Nitin
Gadgade, Bahubali Deepak
Shivapur, Achyuth Ananth
Radhakrishna, Veerabhadra
Vasudev, Raghunath Bangalore
author_sort Kumar, Nitin
collection PubMed
description 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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spelling pubmed-105692752023-10-13 Evaluation and Management of Achalasia Cardia in Children: A Retrospective Observational Study Kumar, Nitin Gadgade, Bahubali Deepak Shivapur, Achyuth Ananth Radhakrishna, Veerabhadra Vasudev, Raghunath Bangalore J Indian Assoc Pediatr Surg Original Article 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. Wolters Kluwer - Medknow 2023 2023-04-25 /pmc/articles/PMC10569275/ /pubmed/37842218 http://dx.doi.org/10.4103/jiaps.jiaps_175_22 Text en Copyright: © 2023 Journal of Indian Association of Pediatric Surgeons https://creativecommons.org/licenses/by-nc-sa/4.0/This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.
spellingShingle Original Article
Kumar, Nitin
Gadgade, Bahubali Deepak
Shivapur, Achyuth Ananth
Radhakrishna, Veerabhadra
Vasudev, Raghunath Bangalore
Evaluation and Management of Achalasia Cardia in Children: A Retrospective Observational Study
title Evaluation and Management of Achalasia Cardia in Children: A Retrospective Observational Study
title_full Evaluation and Management of Achalasia Cardia in Children: A Retrospective Observational Study
title_fullStr Evaluation and Management of Achalasia Cardia in Children: A Retrospective Observational Study
title_full_unstemmed Evaluation and Management of Achalasia Cardia in Children: A Retrospective Observational Study
title_short Evaluation and Management of Achalasia Cardia in Children: A Retrospective Observational Study
title_sort evaluation and management of achalasia cardia in children: a retrospective observational study
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10569275/
https://www.ncbi.nlm.nih.gov/pubmed/37842218
http://dx.doi.org/10.4103/jiaps.jiaps_175_22
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