Diagnosis, misdiagnosis, and associated diseases of achalasia in children and adolescents: a twelve-year single center experience

Purpose Although achalasia is a rare disorder in children, its symptom may mimic common childhood diseases. This study aimed to assess the diagnosis and management of achalasia in children and adolescents in a Brazilian single center during a 12-year period. Methods Patients with achalasia were iden...

Full description

Saved in:
Bibliographic Details
Published in:Pediatric surgery international 2012-12, Vol.28 (12), p.1211-1217
Main Authors: Hallal, Cristiane, Kieling, Carlos O., Nunes, Daltro L., Ferreira, Cristina T., Peterson, Guilherme, Barros, Sérgio G. S., Arruda, Cristina A., Fraga, José C., Goldani, Helena A. S.
Format: Article
Language:English
Subjects:
Adolescent
Child
Child, Preschool
Diagnostic Errors
Esophageal Achalasia - complications
Esophageal Achalasia - diagnosis
Female
Humans
Infant
Male
Medicine
Medicine & Public Health
Original Article
Pediatric Surgery
Pediatrics
Retrospective Studies
Surgery
Time Factors
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Purpose Although achalasia is a rare disorder in children, its symptom may mimic common childhood diseases. This study aimed to assess the diagnosis and management of achalasia in children and adolescents in a Brazilian single center during a 12-year period. Methods Patients with achalasia were identified from a database built during the period of January 2000–January 2012 from a Pediatric Gastroenterology reference center. Information regarding demographic data, clinical symptoms, diagnosis, treatment, and long-term follow-up were described. Results Thirteen patients were studied; median age was 7 (1–14) years. Most frequent symptoms were vomiting (84.6 %) and dysphagia (69.2 %). Weight loss occurred in 46.0 % of patients and chronic cough in 46.1 %. Associated disorders were Down’s syndrome, Allgrove syndrome, and congenital central hypoventilation syndrome. Achalasia was misdiagnosed with anorexia nervosa. Six patients were previously treated as having gastroesophageal reflux disease and asthma. Five patients had pneumatic balloon dilation as initial therapy whereas five had esophageal myotomy. Finally, 11 patients had surgical therapy with a favorable follow-up. Conclusion Achalasia symptoms may mimic common diseases in children, and therefore, may delay the diagnosis. This study emphasizes the importance of the clinical symptoms for the diagnosis of achalasia, mainly in those cases with associated disorders.
ISSN:0179-0358
1437-9813
DOI:10.1007/s00383-012-3214-3