Rela Hospital, Chennai, has achieved a significant milestone in paediatric gastroenterology by successfully treating an eight-year-old boy with Type II achalasia cardia, a rare disorder that affects the ability to swallow food and liquids. The hospital performed Tamil Nadu’s first paediatric Peroral Endoscopic Myotomy (POEM), an advanced minimally invasive procedure.
The child had been experiencing progressively increasing difficulty swallowing both solid food and liquids. Following the procedure, his recovery was satisfactory, and he was able to start clear liquids and subsequently a soft diet within 24 hours.
Achalasia cardia is a disorder in which the lower oesophageal sphincter fails to relax properly, preventing food from passing easily into the stomach. Although rare in children, the condition can lead to nutritional deficiencies, poor growth and other complications if left untreated. Its reported annual incidence among children is approximately 0.1–0.18 per 100,000.
POEM offers an alternative to conventional laparoscopic surgery. The procedure involves inserting an endoscope through the mouth and creating a small tunnel within the oesophageal wall to release the muscles causing the obstruction. Unlike conventional surgery, it requires no external incisions or stitches.
The procedure was performed by Dr. SNK Chenduran, Senior Consultant and Endoscopic Surgeon, Department of Medical Gastroenterology, with support from the hospital’s anaesthesia, paediatric and nursing teams. It was completed in approximately 50 minutes.
Dr. Chenduran said, “Performing POEM in an eight-year-old child requires considerable technical expertise and precision, as the oesophagus in children is much smaller and narrower than in adults, providing very limited working space to perform the procedure. Further creating a tunnel within the wall of the oesophagus requires meticulous dissection in the correct tissue plane for delicate tissues in children. Despite these challenges, we successfully completed the procedure in approximately 50 minutes. This is an important advancement in offering children with this rare condition an effective, minimally invasive treatment option.”
Dr. Dinesh Jothimani, Director – Hepatology and Medical Gastroenterology, Rela Hospital, highlighted the importance of early diagnosis. He urged parents to watch for symptoms such as difficulty swallowing, regurgitation of undigested food, repeated vomiting, unexplained weight loss and coughing while eating. Timely medical evaluation can help prevent complications, including malnutrition and respiratory problems.
Prof. Mohamed Rela, Chairman and Managing Director, Rela Hospital, said, “While POEM is an established treatment for achalasia in adults, performing it in children calls for a much higher degree of technical precision and specialised expertise. Only a limited number of advanced therapeutic endoscopists and centres have the expertise to perform paediatric POEM. Successfully performing this procedure for the first time in Tamil Nadu marks a significant milestone in the state’s advanced therapeutic endoscopy capabilities. It reflects our commitment to bringing highly specialised, minimally invasive treatment options to children, enabling them to benefit from incisionless procedures, potentially quicker recovery and an earlier return to normal activities.”
The achievement highlights the growing capabilities of advanced therapeutic endoscopy in India, offering children with rare gastrointestinal disorders access to specialised treatment with the potential for faster recovery.
(The above image is AI-generated and is for illustrative purposes only)