An Adolescent with Vomiting and Weight Loss

Abstract

Pediatric Achalasia is a rare condition in children, often presents with common symptoms of vomiting and weight loss. We present a case of a 15-year-old female with persistent vomiting and weight loss who was initially diagnosed with eosinophilic esophagitis (EoE) due to endoscopic findings and elevated eosinophils on esophageal histology. After clinical worsening with EoE therapy, a broader workup showed classic bird beak on upper gastrointestinal series and subsequent esophageal manometry confirmed a diagnosis of achalasia. Our case report reinforces the need to review the differential diagnosis of esophageal eosinophilia from common disorders such as gastroesophageal reflux disease and EoE to rare conditions such as achalasia.