An unusual achalasic sigmoid esophagus

  • Narendra Pandit MS, MCh, Surgical gastroenterology Division, department of Surgery, BPKIHS, Dharan
  • Vijay Shrestha
  • Laligen Awale
  • Lokesh Shekher Jaiswal


Achalasia cardia is a rare primary esophageal motility disorder with an incidence of about 1 in 100,000 individuals. If left untreated or inappropriately treated, the disease may progress to end-stage achalasia characterized by megaesophagus or sigmoid esophagus. The presentation as severe malnutrition, anemia, hypoalbuminemia, and asymptomatic tracheal compression has not been described in the setting of the sigmoid esophagus, in absence of underlying malignancy. Here we report an interesting case of a young male, who presented with the above features and managed excellently by open Heller’s myotomy under epidural anesthesia due to the poor performance status.


1. Boeckxstaens GE, Zaninotto G, Richter JE. Achalasia. Lancet 2014;383(9911):83–93. DOI:10.1016/S0140-6736(13)60651-0

2. Richter JE. Oesophageal motility disorders. Lancet. 2001;358(9284):823–8.
3. Herbella FAM, Patti MG. Laparoscopic Heller myotomy and fundoplication in patients with end-stage achalasia. World Journal of Surgery. 2015;39(7):1631–3.
4. Abubakar U, Bashir MB, Kesieme EB. Pseudoachalasia: A review. Nigerian Journal of Clinical Practice. 2016;19(3):303–7.
5. Eckardt AJ, Eckardt VF. Current clinical approach to achalasia. World Journal of Gastroenterology. 2009;15(32):3969–75. DOI:10.3748/wjg.15.3969
6. Kaths JM, Foltys DB, Scheuermann U, Strempel M, Niebisch S, Ebert M, et al. Achalasia with megaesophagus and tracheal compression in a young patient: A case report. Int J Surg Case Rep. 2015;14:16–8.
7. Blam ME, Delfyett W, Levine MS, Metz DC, Katzka DA. Achalasia: A disease of varied and subtle symptoms that do not correlate with radiographic findings. Am J Gastroenterol. 2002;97(8):1916–23. DOI:10.1111/j.1572-0241.2002.05900.x

8. Schlottmann F, Herbella F, Allaix ME, Patti MG. Modern management of esophageal achalasia: From pathophysiology to treatment. Curr Probl Surg [Internet]. 2018;55(1):10–37. Available from:
9. Sweet MP, Nipomnick I, Gasper WJ, Bagatelos K, Ostroff JW, Fisichella PM, et al. The outcome of laparoscopic heller myotomy for achalasia is not influenced by the degree of esophageal dilatation. J Gastrointest Surg. 2008;12(1):159–65.
How to Cite
PANDIT, Narendra et al. An unusual achalasic sigmoid esophagus. J Soc Surg Nep, [S.l.], v. 22, n. 2, p. 35-37, jan. 2020. ISSN 2392-4772. Available at: <>. Date accessed: 27 jan. 2020.