Abstract :Objectives: Once anatomical causes are ruled-out, esophageal manometry is the test of choice for
diagnosis for esophageal dysmotilities in children. There are currently two types: water-perfused
conventional manometry (conventional EM) and high-resolution esophageal manometry (HREM).
HREM has been introduced recently and has become the standard of care. There is scarcity of
information on pediatric esophageal dysmotilities and therefore, the aim of our study was to observe
and describe the etiologies of these disorders in children at our center over a period of 12 years.
Methods: We retrospectively reviewed medical records of a cohort of patients who underwent
esophageal manometry studies from January 2001 to June 2013. We recorded age, gender, year of
study, indication and results.
Results: A total of 94 subjects were selected for our study. The median age of children in our study
was 13 years. In our cohort, the most common indication for manometry was dysphagia (80%).
We found that 38% of our subjects had normal motility. The most frequently diagnosed conditions
were achalasia (22%) and ineffective esophageal motility disorder/minor peristaltic abnormalities
(HREM) (22%). Other diagnoses included hypotensive LES, found in 8%, esophageal spasms found
in 4%, and hypertensive LES/EGJ outflow obstruction (HREM) which was found in 4% of subjects.
Two percent of our subjects had scleroderma, while 0% was found to have hypertensive peristalsis
of the esophagus (Nutcracker esophagus/Jackhammer esophagus).
Conclusion: As in adult studies, our observation in children revealed that achalasia and ineffective
esophageal motility disorder/minor peristaltic abnormalities (HREM) accounted for most of the
motility disorders that were detected. Further studies will be useful to investigate the characteristics
of patients diagnosed with these disorders.