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CHILDHOOD ACHALASIA IN ZARIA, NIGERIA

L.B. CHIRDAN, E.A. AMEH, P.T. NMADU

Abstract


Objectives: Tostudy the presentation, management and outcomeofachalasia of theoesophagus
in children.
Design: A retrospective case study.
Setting: Ahmadu Bello University Teaching Hospital, Zaria, Nigeria.
Subjects: 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 anda Thal fundoplicationin a threemonth 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.
Conclusion: 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.

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