title: Esophageal achalasia of unknown etiology in infants.
abstract: BACKGROUND
  Achalasia cardia is an uncommon disease in children particularly in infants. We present 8 cases of achalasia who were encountered over a 12-year period. In infantile achalasia, respiratory symptoms predominate and vomiting may easily be mistaken for gastroesophageal reflux (GER). Vomiting of uncurdled milk is characteristic of achalasia.
  
  
  METHODS
  In this retrospective study, the data were obtained from records of the Department of Pediatric Surgery IMS, BHU Varanasi, India. The patients were diagnosed by clinical examination and barium study. Any other associated anomalies were noted in these patients. The patients underwent esophagocardiomyotomy with antireflux procedure via the abdominal route.
  
  
  RESULTS
  In the present series, 7 patients survived. The follow-up study after operation showed remarkable relief of symptoms with satisfactory weight gain. No post-operative death occurred in the patients. Achalasia associated with alacrimia was noted in one infant who was lost to follow up. One infant was initially diagnosed as having gastric volvulus, but exploration revealed achalasia cardia.
  
  
  CONCLUSIONS
  Esophageal achalasia is a rare disease in children and its origin is generally indeterminable. Achalasia cardia should be emphasized in the differential diagnosis of an infant presenting with signs and symptoms of esophageal obstruction.
authors.affiliation: Department of Pediatric Surgery, IMS, BHU, Varanasi, India. upadhyayavj@rediffmail.com
authors.forename: Vijay D
authors.initials: VD
authors.lastname: Upadhyaya
authors.forename: A N
authors.initials: AN
authors.lastname: Gangopadhyaya
authors.forename: D K
authors.initials: DK
authors.lastname: Gupta
authors.forename: S P
authors.initials: SP
authors.lastname: Sharma
authors.forename: Vijayendra
authors.initials: V
authors.lastname: Kumar
authors.forename: S C
authors.initials: SC
authors.lastname: Gopal
mesh_terms: D001464:Barium; D004931:Esophageal Achalasia / Q000175:diagnosis* / Q000209:etiology* / Q000601:surgery; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D011379:Prognosis; D035583:Rare Diseases; D012189:Retrospective Studies
chemical_list: D001464:Barium