Clinical and ultrasound approach to achalasia in a child. Case report

Achalasia is a primary esophageal motor disorder of unknown etiology characterized by insufficient lower esophageal sphincter (LES) relaxation in response to deglution. We present the case of a child diagnosed with asthma, with no response to asthma treatment. On account of associating dysphagia, regurgitation of food and weight loss he was given an abdominal ultrasound that revealed a massive dilated and narrowing of its distal segment esophagus. Ultrasound examination proved to be a good diagnostic tool, reorienting from the initial asthma diagnosis to the correct achalasia diagnosis, confirmed through barium swallow, upper digestive endoscopy and esophageal manometry. Esocardiomiotomy with antireflux technique was performed with excellent results.