Chest pain and dysphagia in adolescents caused by diffuse esophageal spasm.
Five adolescents, 13-18 years of age, underwent esophageal manometric studies because of chronic symptoms suggestive of esophageal dysfunction. Four of five patients had episodic nonexertional midchest pain; two patients experienced intermittent dysphagia. The manometric findings for these adolescents were consistent with a primary motility disorder known as diffuse esophageal spasm, a condition not previously reported in this age group. This represents approximately 1% of all pediatric patients undergoing esophageal manometry at our institution for the past 5 years. They have been followed for at least 2 years and three have experienced gradual resolution of their symptoms with normalization of manometric findings. Our report emphasizes two main points: (a) Diffuse esophageal spasm may cause chest pain and dysphagia in adolescents; and (b) the clinical history and esophageal manometric findings establish the diagnosis of diffuse esophageal spasm.
Milov
D E
DE
Department of Pediatrics, University of Florida, Gainesville 32610.
Cynamon
H A
HA
Andres
J M
JM
D000293:Adolescent; D002637:Chest Pain / Q000209:etiology*; D003680:Deglutition Disorders / Q000209:etiology*; D003937:Diagnosis, Differential; D015155:Esophageal Spasm, Diffuse / Q000150:complications*; D005260:Female; D006801:Humans; D008297:Male; D008365:Manometry