Anaesthetic challenges of achalasia cardia

Poor peristalsis and an inability to relax the lower esophageal sphincter are symptoms of achalasia cardia, a chronic neurodegenerative motility condition of the oesophagus. (LES). The primary problem with remedial operations for achalasia cardia is pulmonary aspiration of esophageal residual contents during induction of general anaesthesia. The timing of nil per oral or endoscopic clearance of esophageal contents prior to induction of anaesthesia is not governed by any universally accepted standards. We present the case of a 43-year-old man with a history of hypertension, diabetes