[Cricopharyngeal achalasia: diagnosis and therapeutic alternatives].

INTRODUCTION: The cricopharyngeal achalasia is an esophageal motor disorder that entails a lack of relaxation of the upper esophageal sphincter. It is rare in children and its etiology is related to multiple factors. The symptoms are nonspecific and may be masked by other diseases.

CLINICAL CASE: Report two infants with dysphagia and choking episodes. Upper gastrointestinal series confirmed cricopharyngeal achalasia. The first patient was treated with endoscopic dilatation, and did not require further therapies. In the second patient, despite numerous dilatations and myotomy, the symptoms persisted so he received botulinum toxin injections.

COMMENTS: Diagnosis of achalasia is obtained by upper gastrointestinal series and thanks to a high index of clinical suspicion. The use of endoscopic dilatation is the first option because it is not an invasive technique, but it usually requires several sessions. The second-line therapy is surgery, a more aggressive technique. In addition, the injection of botulinum toxin represents a safe and effective alternative, although it is a less widespread method in pediatrics.