Childhood achalasia in Zaria, Nigeria.
Maneno muhimu
Kikemikali
OBJECTIVE
To study the presentation, management and outcome of achalasia of the oesophagus in children.
METHODS
A retrospective case study.
METHODS
Ahmadu Bello University Teaching Hospital, Zaria, Nigeria.
METHODS
Seven children managed for achalasia of the oesophagus in a period of 19 years.
RESULTS
There were six boys and one girl. The median age at presentation was ten years (range three months to fifteen years). The median duration of symptoms before presentation was 20 months (range: 2-24 months). Three children were treated on several occasions for pneumonia before the diagnosis was made. Dysphagia, vomiting and regurgitation were the main presenting symptoms. Diagnosis was by barium oesophagogram. Six had modified Heller's myotomy via celiotomy and a Thal fundoplication in a three month old. Transthoracic Heller's myotomy was done in the seventh child. There was complete resolution of symptoms in six children. One patient had post-operative retrosternal pain, which was controlled by oral nifedipine.
CONCLUSIONS
Achalasia of the oesophagus should be excluded in children with recurrent chest infection. Modified Heller's myotomy without antireflux procedure via the abdominal route is effective in relieving symptoms of achalasia in children.
