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Abstract:

Achalasia in children is a rare motility disorder of the esophagus. It is characterised by absent peristaltic contractions in the body of the esophagus and an elevated pressure in the lower esophageal sphincter causing a functional obstruction. The etiology is not yet fully understood, but there is evidence of an inflammatory degeneration of NO-producing neurons in the myenteric plexus causing a lack of inhibitory innervation of the lower esophageal sphincter. The diagnosis of achalasia in children is often not evident. Symptoms can mimic feeding disorders and respiratory diseases. Diagnosis can be confirmed by radiography, endoscopic examination and finally proven by manometric measurements. Treatment in children aims long-term results. Surgical myotomy of the lower esophageal sphincter combined with an antireflux procedure is the treatment of choice. Laparoscopic approach shortens postoperative recovery.