ACHALASIA OF THE CARDIA - A PEDIATRIC CASE REPORT

Abstract

Introduction: Achalasia is an esophageal motor disorder characterized by aperistalsis of the esophageal body and lack of relaxation of the lower sphincter in response to swallows. It affects both sexes and all age groups. The exact etiology of this degeneration is unclear though many theories have been proposed. Possible etiology of achalasia can be familial, infection or autoimmune. Patients often present with progressive dysphagia to solids and liquids, heartburn, chest pain, regurgitation, and varying degrees of weight loss or nutritional deficiencies. Case report: In January 2020, a 10 years old boy was admitted to our hospital due to vomiting, chest pain during swallowing, and prolonged cough. A lot of investigations were performed. Fyberbronchoscopy showed that the trachea, the right main bronchus and the left main bronchus were with anteroposterior narrowed lumen. Computed tomography of thorax and abdomen showed dilated esophagus with largest diameter of 45 mm subcarinal with retained content.There is a compression of the right hillus. The finding indicates achalasia of the cardia. One month after the hospital stay, the child was admitted at the Clinic for pediatric surgery. Laparoscopic Heller Myotomy (LHM) with antireflux Dor fundoplication was performed. The following period the boy has no gastric or respiratory symptoms. Conclusion: We can conclude that it is worth to suspect achalasia in a pediatric patient with prolonged cough and recurrent respiratory infections refractory to conventional treatments such as bronchodilators, especially if the patient also has a history of vomiting and dysphagia.