542 A Rare Cause of Swallowing Difficulty that should be always in Mind

Aim Swallowing difficulty among children is not a frequent complaint. Generally this problem is associated with gastroesophageal reflux, esophagitis, and rarely is seen as an outcome of esophageal strictures. We report here a boy who was admitted to our clinic with swallowing difficulty but finally had a different diagnose. Material and method A 6-year-old boy was admitted due to swallowing difficulty. The family was in France and the child had this complaint almost for 4 months. The boy had lost 5kg but still was in the 50th centile both for weight and height. His physical, neurological and fundoscopic examinations were normal. But he was in a bad mood and seemed exhausted. He told that he could not swallow large particles and his portions became smaller gradually. Esophageal narrowing/stricture was thought thus Barium enema was performed and showed a normal esophagus. Then upper gastrointestinal endoscopy was performed, Endoscopical esophagitis and gastritis was confirmed by pathology with H. pylori gastritis. Although the boy was put on PPI and antibiotics his complaints did not improve, and he was still in a depressed mood. Finally a cranial MR was taken and showed a 4×3cm diameter mass located in the inferior vermis and 4th ventricle advancing to foramen magnum. Conclusion Swallowing difficulties in children is generally due to mild problems such as gastroesophageal reflux, esophagitis or food allergies. If swallowing difficulty is together with weight loss and is persistant for months intracranial pathologies, as in our case, should be searched.