Published: 2022-06-23

Persistent vomiting and failure to thrive as manifestation of achlasia cardia in a chid: a case report

Nargis Banoo, Manzoor Hussain


Achlasia cardia is rare in paaediatric age group, here we present an 18 months old child with recurrent episodes of non bilious vomiting since 12 month of age and failure to thrive. Diagnosis was made on the basis of barium oesophagogram and endoscopic pneumatic dilatation was done which resulted in significant improvement in symptoms.


Achlasia, Failure to thrive, GERD, Persistent vomiting, Balloon dilatation

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Smits M, Van Lennep M, Vrijlandt R. Pediatric Achalasia in the Netherlands: incidence, clinical course and quality of life. J Pediatr. 2016;169:110.e3-5.

Walzer N, Hirano I. Achalasia. Gastroenterol Clin North Am. 2008;37:807-25.

Lee CW, Kays DW, Chen MK, Islam S. Outcomes of treatment of childhood achalasia. J Pediatr Surg. 2010;45:1173-7.

Hallal C, Kieling CO, Nunes DL, Ferreira CT, Peterson G, Barros SG et al. Diagnosis, misdiagnosis, and associated diseases of achalasia in children and adolescents: a twelve-year single center experience. Pediatr Surg Int. 2012;28:1211-7.

Park W, Vaezi MF. Etiology and pathogenesis of achalasia: the current understanding. Am J Gastroenterol. 2005;100:1404-14.

Rai GS, Sarawagi R, Sharma S, Apte A. An infant with nasal regurgitation since birth and failure to thrive. J Clin Diagn Res. 2015;9:3.

Krill JT, Naik RD, Vaezi MF. Clinical management of achalasia: current state of the art. Clin Exp Gastroenterol 2016;9:71-82.

Singendonk MM, Smits MJ, Heijting IE. Inter- and intrarater reliability of the Chicago Classification in pediatric high-resolution esophageal manometry recordings. Neurogastroenterol Motil. 2015;27:269-76.

Singendonk MMJ, Rosen R, Oors J. Intra- and interrater reliability of the Chicago Classification of achalasia subtypes in pediatric high resolution esophageal manometry recordings (HRM). Neurogastroenterol Motil. 2017;29:e13113.

Lee CW, Kays DW, Chen MK, Islam S. Outcomes of treatment of childhood achalasia. J Pediatr Surg. 2010;45(6):1173-7.

Babu R, Grier D, Cusick E, Spicer RD. Pneumatic dilatation for childhood achalasia. Pediatr Surg Int. 2001;17:505-7.

Pastor AC, Mills J, Marcon MA, Himidan S, Kim PC. A single center 26-year experience with treatment of esophageal achalasia: is there an optimal method? J Pediatr Surg. 2009;44:1349-54.

Nakayama DK, Shorter NA, Boyle JT, Watkins JB, O’Neill JA. Pneumatic dilatation and operative treatment of achalasia in children. J Pediatr Surg. 1987;22:619-22.

Di Nardo G, Rossi P, Oliva S, Aloi M, Cozzi DA, Frediani S et al. Pneumatic balloon dilation in pediatric achalasia: efficacy and factors predicting outcome at a single tertiary pediatric gastroenterology center. Gastrointest Endosc. 2012;76:927-32.

Wang L, Li YM, Li L, Yu CH. A systematic review and meta-analysis of the Chinese literature for the treatment of achalasia. World J Gastroenterol. 2008;14:5900-6.

Patti MG, Fischella PM. Controversies in management of Achalasia. J Gastrointest Surg. 2014;18:1705-9.

Esposito C, Riccipetitoni G, Chiarenza SF, Roberti A, Vella C, Alicchio F et al. Long-term results of laparoscopic treatment of esophageal achalasia in children: a multicentric survey. J Laparoendosc Adv Surg Tech A. 2013;23:955-9.