Abstract

Introduction: Esophageal achalasia is a rare condition in children, with the incidence ranging from 0.11 / 100.000 to 0.18 / 100.000 per year. Only 5% of patients with achalasia have the onset of symptoms before 14 years of age. Establishing prompt diagnosis of achalasia in children is difficult and more than half of cases are diagnosed at an older age. Treatments consist of several modalities such as open surgery with modified Heller’s myotomy, minimally invasive surgery with laparoscopic Heller’s myotomy, and robotic surgery. Case Report: A 3-year old child was admitted with vomiting every time the patient consumed solid food. The complaint is present since birth. Vomiting is experienced following consumption of solid food or drinking in large quantities. Defecation and urination are normal. Patient’s weight increases according to her age. From physical examination no meaningful finding was found, but from history taking, achalasia of the esophagus was suspected that was later confirmed by esophagography. Conclusion: Repair of the achalasia was performed via Heller’s myotomy with Niessen fundoplication, giving good results after 6 months of follow up with the patient now able to ingest food normally without any difficulties, and regaining weight according to her age. We conclude that Heller’s myotomy with Niessen fundoplication is a safe and technically easy procdure to perform while still giving good results, and should be the treatment of choice for achalasia esophagus in children.

Key words: Achalasia, Esophagus, Heller myotomy, Lower esophageal sphincter