Pediatric Esophageal Achalasia: Navigating Rare Challenges in Young Patients

Abstract

This case report describes a 9-year-old girl diagnosed with esophageal achalasia after a 5-year delay in treatment, presenting initially with aspiration pneumonia and respiratory failure. Esophageal achalasia is a rare neurodegenerative disorder predominantly affecting adults, with pediatric cases comprising less than 2% of diagnoses. In our case of pediatric esophageal achalasia complicated by aspiration pneumonia and respiratory failure. Initially managed for fever and respiratory symptoms with outpatient antibiotics, her condition deteriorated rapidly, necessitating hospitalization. Clinical examination revealed respiratory failure, persistent regurgitation, and severe malnutrition. A diagnostic workup confirmed aspiration pneumonia, underscoring the diagnostic challenges in pediatric achalasia. The treatment plan involved fluid resuscitation, antibiotics, and surgical intervention post- stabilization. This case highlights the critical importance of early recognition and intervention in pediatric esophageal achalasia to mitigate severe complications. Awareness among clinicians is essential, as delayed treatment can lead to profound morbidity in young patients. Further studies are warranted to enhance diagnostic strategies and optimize outcomes in this rare pediatric population.