Cricopharyngeal achalasia, a rare cause of chronic irritable cough in infant

Česká verze

Authors: A. Jovankovičová ¹; J. Jakubíková ¹; J. Bibza ²
Authors place of work: Detská ORL klinika LFUK a DFNsP, Bratislava prednostka prof. MUDr. J. Jakubíková, CSc. ¹; Klinika detskej chirurgie LFUK a DFNsP, Bratislava prednosta MUDr. J. Trnka, CSc. ²
Published in the journal: Čes-slov Pediat 2011; 66 (2): 99-102.
Category: Kazuistika

Summary

Cricopharyngeal achalasia is a rare clinical diagnosis characterized by impaired relaxation of the upper esophageal sphincter (cricopharyngeal muscle) during deglutination. We report about 7-month old girl with a history of permanent dry irritable cough lasting several months, which was unsuccessfully treated with repeated antibiotic therapy. Esophagography and subsequent endoscopy of the esophagus and trachea under general anesthesia revealed the cause of the difficulties.

Purpose of this case report is to draw attention to the less frequent cause of recurrent inflammation of the lower respiratory tract and dysphagia in children as well as to demonstrate the suitability of esophagography in determination of the correct diagnosis.

Key words:
cricopharyngeal achalasia, irritable cough, dysphagia, esophagography

Zdroje

1. Walker A, et al. Pediatric gastrointestinal disease 5. PMPH –⁠ USA, 2008 : 47–85.

2. Bitvai K, Madarasi A, Saringer L, Wollak I. Cricopharyngeal dysfunction and recurring bronchitis of infants. Year book of Pediatric Radiology, Current Problems of Pediatric Radiology, 1999. www.socrad.hu.

3. Utian HL, Thomas RG. Cricopharyngeal incoordination in infancy. Pediatrics 1969; 43 : 402–406.

4. Staiano A, Cucchiara S, De Vizia B, Andreotti MR, Auricchio S. Disorders of upper esophageal sphincter motility in children. J Pediatr Gastroenterol Nutr 1987; 6(6): 892–898.

5. Ryan K, Sewell JD, Nancy M, Bauman. Congenital cricopharyngeal achalasia. managment with botulinum toxin before myotomy. Arch Otolaryngol Head and Neck Surgery 2005; 131 : 451–453.

6. Wadhera R, Gulati SP, Garg A. Cricopharyngeal achalasia –⁠ a rare cause of dysphagia. Otolaryngol Head and Neck Surgery 2008; 60 : 183–184.

7. Zepeda-Goméz S, Montano Loza A, Valdovinos F. Endoscopic balloon catheter dilatation for treatment of primary cricopharyngeal dysfunction. Digestive Diseases and Sciences 2004; 49 : 1612–1614.

8. Bhattacharyya N. Cricopharyngeal myotomy. Oct. 8, 2009, http://emedicine.medscape.com/article/836966-overview.

9. Dantas RO, Cook IJ, Cook WJ. Biomechanics of cricopharyngeal bars. Gastroenterology 1999; 99 : 1269–1274.

10. Sokol EM, Heitmann P, Wolf PS, Cohen BR. Simultaneous cineradiographic and manometric study of the pharynx, hypopharynx and cervical esophagus. Gastroenterology 1996; 51 : 960–974.

11. Mathur NB, Banerjee S, Maria A. Congenital cricopharyngeal achalasia. Indian Pediatr 2001; 38 : 783–788.

12. Salib SA, Aubert D, Valioulis I, de Billy B. Cricopharyngeal achalasia –⁠ a cause of major dysphagia in a newborn. Eur J Pediatr Surg 1999; 9 : 406–408.

13. Hussian SZ, Di Lorenzo C. Motility disorders: diagnosis and treatment for the pediatric patient. Pediatr Clin North Am 2002; 49 : 27–51.

14. Hromádková P, Murár E, Bibza J, Cingel V, Horn F. Vrodená stenóza pažeráka asociovaná s Chiariho malformáciou u 8-ročného dieťaťa. Pediatria (Bratisl.) 2009; 4(3): 147–149.