A two-month-old infant with achalasia: A case report

Abstract

Achalasia is a primary functional motor disorder of the lower esophageal sphincter, characterized by abnormal esophagus motility and failure to relax the lower esophageal sphincter. Herein, we present a case of a two-month-old female infant who was operated on with a diagnosis of achalasia. The baby was born at 39 weeks with cesarean section, with a birth weight of 3180 g, and referred to the pediatric surgery clinic with the suspicion of tracheoesophageal fistula. Physical examination was unremarkable except for malnutrition. The patient had been receiving gastroesophageal reflux treatment since the neonatal period. An upper gastrointestinal series revealed dilatation in the lower two-thirds of the esophagus and a typical bird's beak appearance at the esophagogastric junction. Heller myotomy with Dor fundoplication was performed. The postoperative follow-up was uneventful. The patient presented is one of the youngest children operated with achalasia in the literature. Achalasia should be kept in mind in the presence of frequent pulmonary infections, weight loss, and oronasal regurgitation unresponsive to antireflux therapy.