Achalasia cardia in a child managed with per-oral endoscopic myotomy: a case report

We present a case of a 12-year-old girl with progressively worsening vomiting and respiratory symptoms, eventually diagnosed with achalasia cardia. Initial imaging and endoscopy suggested esophageal motility disorder, confirmed by high-resolution manometry as type I achalasia. The child underwent per-oral endoscopic myotomy (POEM) procedure after antifungal treatment for incidental esophageal candidiasis. The procedure was successful with complete symptom resolution and weight gain on follow-up. This case highlights the diagnostic challenges in pediatric Achalasia and emphasizes the role of POEM as an effective therapeutic modality.