Document Detail


Achalasia: diagnosis, management, and clinical course in 16 children.
MedLine Citation:
PMID:  6835765     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Clinical features, radiographic and esophageal manometry findings, and treatment results in 16 patients less than 15 years old with achalasia are described. Esophageal manometry performed in 15 patients showed results similar to those found in adults: (1) increased resting lower esophageal sphincter pressure, (2) incomplete or failure of relaxation of the lower esophageal sphincter on swallowing, and (3) ineffective or absence of peristalsis in all. The most common symptoms in the 16 patients were: dysphagia in 15, postprandial vomiting in 13, and retrosternal pain in five. The average duration from onset of symptoms to diagnosis was 28 months. The esophagram was diagnostic in all patients. Pneumatic dilation was the initial treatment in eight and was successful for more than 1 year in five. Two patients required two dilations and were then symptom-free for more than 1 year, but required a Heller myotomy. The remaining patients underwent Heller myotomy following failure of the second dilation. Three patients underwent myotomy and two patients had myotomy with fundoplication as initial treatment; only one remained symptomatic. Esophageal dilation using a pneumatic dilator should be the initial treatment of choice in school-aged children. However, if more than two dilations are required within 1 year, surgical management is recommended.
Authors:
W E Berquist; W J Byrne; M E Ament; E W Fonkalsrud; A R Euler
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Pediatrics     Volume:  71     ISSN:  0031-4005     ISO Abbreviation:  Pediatrics     Publication Date:  1983 May 
Date Detail:
Created Date:  1983-05-27     Completed Date:  1983-05-27     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0376422     Medline TA:  Pediatrics     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  798-805     Citation Subset:  AIM; IM    
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Child
Child, Preschool
Dilatation
Esophageal Achalasia / diagnosis*,  surgery,  therapy
Esophagogastric Junction / physiopathology
Esophagoscopy
Female
Humans
Male
Manometry
Pressure

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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