Achalasia - pediatric

Case contributed by Dr Ammar Haouimi

Presentation

Dysphagia for both solids and liquids with vomiting.

Patient Data

Age: 11 years
Gender: Female

The chest x-ray shows a convex opacity overlapping the right upper mediastinum which may be due to dilated esophagus. Small gastric bubble with aerated splenic flexure. Both lungs are clear. No pleural effusion is seen.

On barium swallow, the esophagus is dilated with tertiary contractions and acute tapering at the lower esophageal sphincter, producing a "bird's beakappearance.

Case Discussion

Achalasia (primary achalasia) is defined as a failure of organized esophageal peristalsis causing impaired relaxation of the lower esophageal sphincter, and resulting in food stasis with often marked dilatation of the esophagus. 

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