# When Vomiting Isn’t Just a Bug: Unmasking Two Rare Causes of Pediatric Dysphagia

## TL;DR

This paper discusses two rare cases of esophageal obstruction in children, emphasizing the need for thorough diagnosis beyond common causes.

## Contribution

The paper contributes by highlighting two uncommon pediatric conditions causing dysphagia and vomiting through case reports.

## Key findings

- A 10-year-old boy with Angelman syndrome was found to have a double aortic arch causing esophageal compression.
- A 13-year-old child with chronic vomiting was diagnosed with primary achalasia.
- The cases underscore the importance of considering structural disorders in pediatric dysphagia.

## Abstract

Pediatric vomiting and feeding difficulties are common presentations in both emergency and outpatient settings. Although these symptoms are often attributed to benign causes such as infections or gastroenteritis, structural and functional esophageal disorders must also be considered. This report describes two diagnostically challenging cases of esophageal obstruction in children. The first involves a 10-year-old boy with Angelman syndrome, ultimately diagnosed with a double aortic arch causing extrinsic esophageal compression. The second case features a previously healthy 13-year-old with chronic vomiting, later identified as having primary achalasia. These cases highlight the importance of maintaining a broad differential diagnosis and employing targeted imaging to prevent delays in diagnosis.