Division of Respiratory Medicine, Montreal Children’s Hospital of the McGill University Health Centre, Montreal, Quebec.
Can Respir J. 2011 Mar-Apr;18(2):81-3. doi: 10.1155/2011/895701.
Achalasia is characterized by obstruction of the distal esophagus and subsequent dilation of the proximal esophagus, and is considered to be a rare disorder in children. Patients commonly present with gastrointestinal (GI) symptoms such as dysphagia; however, pulmonary symptoms may also occur. Rare pulmonary symptoms due to achalasia are dyspnea and wheeze due to tracheal compression. The authors describe an 11-year-old boy who was referred to a pediatric respiratory clinic for asthma that was not responsive to inhaled medications. The child presented with a one-year history of dyspnea on exertion, cough and wheeze. He also complained of chronic dyspepsia. The presence of GI symptoms, in addition to abnormalities on chest radiograph and spirometry, suggested the presence of achalasia. The diagnosis was confirmed and the patient subsequently underwent surgical myotomy that relieved his GI and pulmonary symptoms, and normalized spirometry. The present article is an illustrative case report to remind pediatricians to consider other diagnoses when a patient does not respond to asthma medications.
贲门失弛缓症的特征是食管远端梗阻和随后的食管近端扩张，被认为是儿童中罕见的疾病。患者通常表现为胃肠道（GI）症状，如吞咽困难；然而，也可能出现肺部症状。由于贲门失弛缓症引起的罕见肺部症状是由于气管受压导致的呼吸困难和喘息。作者描述了一名 11 岁男孩，因对吸入药物无反应的哮喘被转介到儿科呼吸诊所。该患儿表现为进行性呼吸困难、咳嗽和喘息，已有一年病史。他还抱怨有慢性消化不良。除了胸部 X 线和肺功能检查异常外，存在胃肠道症状提示存在贲门失弛缓症。诊断得到了确认，随后患者接受了外科肌切开术，缓解了他的胃肠道和肺部症状，并使肺功能正常化。本文是一个说明性病例报告，旨在提醒儿科医生在患者对哮喘药物无反应时考虑其他诊断。
