A Successful Case of Endoscopic Balloon Dilatation for Chicago Classification Type II Pediatric Achalasia

Abstract

Esophageal achalasia is a rare disease in childhood, and there is still no consensus on its prompt treatment and the appropriate timing of treatment. In this paper, we report a successful endoscopic balloon dilation in an 8-year-old girl with esophageal achalasia. The patient suffered from repeated coughing and vomiting at bedtime, and she was diagnosed as having type II esophageal achalasia (Chicago classification) by high-resolution esophageal manometry. On the basis of this diagnosis, she was considered a possible responder to endoscopic balloon dilatation, the least invasive procedure. Multiple balloon dilatations were performed up to 30 mm in incremental steps. After treatment, the patient was able to eat well and had no symptoms, and esophagography showed a decrease in esophageal diameter. The Eckardt score improved from 4 points before treatment to 0 points after treatment. No recurrence was observed two years after treatment and no additional treatment was necessary.