Choking, Regurgitation (Differential Diagnosis)

The esophagography was performed in this 5-month-old girl because of choking and suspected regurgitation during feeding. The middle of the esophagus is severly dilated, and no entrance of contrast into the abdominal eophagus is visible. Again, the diagnosis is an achalasia of the distal esophagus in a very young infant. The diagnosis was confirmed by esophageal manometry, esophagoscopy and biopsy of the distal esophagus with missing ganglion cells. The achalasia is a rare disease in childhood, but occurs in infants, too, and is therefore a differential diagnosis of hypertrophic pyloric stenosis.