# Sudden-Onset Back Pain and Intermittent Dyspnea While Eating: A Case of Pediatric Achalasia

## TL;DR

A 14-year-old girl with unusual back and chest pain was diagnosed with rare pediatric achalasia, a condition causing swallowing and breathing issues, and successfully treated with surgery.

## Contribution

Highlights the rare presentation of pediatric achalasia with atypical musculoskeletal and respiratory symptoms.

## Key findings

- CT imaging showed a severely dilated esophagus consistent with type 1 achalasia.
- Esophageal manometry confirmed lack of contractions and sphincter relaxation.
- Laparoscopic Heller myotomy provided symptom relief.

## Abstract

A 14-year-old girl with a history of asthma was hospitalized because of sudden-onset back pain around her thoracic region that spread to her chest and abdomen. She had been experiencing dysphagia and breathing difficulties for two years, especially after overeating, which often resulted in vomiting undigested food. CT imaging revealed a severely dilated esophagus narrowing at the gastroesophageal junction, suggestive of type 1 achalasia. Further testing confirmed the diagnosis, with an esophageal manometry showing a lack of esophageal contractions and sphincter relaxation. She then underwent a laparoscopic Heller myotomy with relief to her symptoms. This case underscores the rarity of pediatric-onset achalasia with significant esophageal dilation and secondary airway compression, presenting with unusual musculoskeletal and respiratory symptoms. Timely diagnosis and treatment are crucial to prevent worsening and complications.