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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Main Authors: Nitin Kumar, Bahubali Deepak Gadgade, Achyuth Ananth Shivapur, Veerabhadra Radhakrishna, Raghunath Bangalore Vasudev
Format: Article
Language:English
Published: Wolters Kluwer Medknow Publications 2023-01-01
Series:Journal of Indian Association of Pediatric Surgeons
Subjects:
Online Access:http://www.jiaps.com/article.asp?issn=0971-9261;year=2023;volume=28;issue=5;spage=369;epage=374;aulast=Kumar
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author Nitin Kumar
Bahubali Deepak Gadgade
Achyuth Ananth Shivapur
Veerabhadra Radhakrishna
Raghunath Bangalore Vasudev
author_facet Nitin Kumar
Bahubali Deepak Gadgade
Achyuth Ananth Shivapur
Veerabhadra Radhakrishna
Raghunath Bangalore Vasudev
author_sort Nitin Kumar
collection DOAJ
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 doaj.art-357ab19137274a95bfa689d4aab869882023-10-30T10:03:35ZengWolters Kluwer Medknow PublicationsJournal of Indian Association of Pediatric Surgeons0971-92611998-38912023-01-0128536937410.4103/jiaps.jiaps_175_22Evaluation and management of achalasia cardia in children: A retrospective observational studyNitin KumarBahubali Deepak GadgadeAchyuth Ananth ShivapurVeerabhadra RadhakrishnaRaghunath Bangalore VasudevBackground: 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.http://www.jiaps.com/article.asp?issn=0971-9261;year=2023;volume=28;issue=5;spage=369;epage=374;aulast=Kumarachalasia cardiacardiomyotomyfundoplicationgastroesophageal reflux disease
spellingShingle Nitin Kumar
Bahubali Deepak Gadgade
Achyuth Ananth Shivapur
Veerabhadra Radhakrishna
Raghunath Bangalore Vasudev
Evaluation and management of achalasia cardia in children: A retrospective observational study
Journal of Indian Association of Pediatric Surgeons
achalasia cardia
cardiomyotomy
fundoplication
gastroesophageal reflux disease
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 achalasia cardia
cardiomyotomy
fundoplication
gastroesophageal reflux disease
url http://www.jiaps.com/article.asp?issn=0971-9261;year=2023;volume=28;issue=5;spage=369;epage=374;aulast=Kumar
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AT veerabhadraradhakrishna evaluationandmanagementofachalasiacardiainchildrenaretrospectiveobservationalstudy
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