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Achalasia — RACP Paediatrics MCQ

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HardGastroenterologyAchalasiaRACP Paediatrics

A 15-year-old presents with progressive dysphagia. Barium swallow shows a dilated oesophagus with a bird-beak appearance at the lower oesophageal sphincter. Manometry shows absent peristalsis and failure of LOS relaxation. Diagnosis?

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Correct answer: B — Achalasia

Achalasia is caused by loss of inhibitory ganglion cells in the myenteric plexus of the oesophagus, resulting in failure of LOS relaxation and absent peristalsis. Treatment includes pneumatic balloon dilatation or Heller myotomy. It is rare in children but should be considered for progressive dysphagia.

Reference: RCH Melbourne – 2024 – Clinical Practice Guidelines: Oesophageal Motility Disorders