[Achalasia in children].

Achalasia is a pathology which was first described more than 300 years ago, it is relatively rare in children. Four cases of childhood achalasia were studied in children admitted to the J. M. de los Ríos Hospital during the period January, 1971 to June, 1990. The clinical presentation was characterized by progressive dysphagia to solids and liquids, regurgitations, weight loss and in certain cases, a moist cough, predominantly nocturnal. The diagnostic workup carried out included radiological, endoscopic and manometric studies. They were helpful to diagnose the following positive signs: esophageal dilation with alteration of motility and a small caliber cardio-esophageal junction, in addition to an elevation of the inferior esophageal sphincteric pressure with non-peristaltic esophageal contractions. The Starck dilator was used to create a mechanical disruption of the muscle fibers of the inferior esophageal sphincter. The procedure improved the clinical symptoms, lowered the inferior esophageal sphincteric pressure leading to adequate pondostatural progress and a satisfactory evolution.