25-yr progressive dysphagia

Achalasia Cardia

Clinical Features

→ Female : 25-yr progressive dysphagia

→ Liquids > Solid (Dysphagia)

→ Food sticks behind sternum

→ Halitosis / Regurgitations of food items / Recurrent Pneumonia

IOC

→ Esophageal manometry (LES tone ↑)

Ba swallow : Bird beak appearance

Rx

→ Laparoscopic Heller’s myotomy + Nissen fundoplication

→ Botulinum toxin+ Balloon dilatation + CCB