case_images: PMC8683483_01
case_images: PMC8683483_02
case_images: picture showing the wasted patient; prominent ribs (yellow arrow) and thin limbs (red arrow)
case_images: PAMJ-40-155-g001.jpg
case_images: PMC8683483_02_PAMJ-40-155-g001.jpg
case_images: F1
case_images: He weighed 26 Kg and had a height of 124 Cm, his body mass index (BMI) was 11.9 Kg/m2, (Figure 1).
case_images: esophagogram showing the classic bird s beak of achalasia (yellow arrow) and dilatated esophagus above
case_images: PAMJ-40-155-g002.jpg
case_images: PMC8683483_02_PAMJ-40-155-g002.jpg
case_images: F2
case_images: Imaging included an esophagogram which showed a dilated esophagus, with stasis of the contrast meal and a progressive narrowing picturing the classic bird s beak of achalasia cardia (Figure 2).
case_images: intraoperative image of the cardiomyotomy extending from the esophagus to the upper part of the anterior side of the stomach; note the bulging mucosa (yellow arrow)
case_images: PAMJ-40-155-g003.jpg
case_images: PMC8683483_02_PAMJ-40-155-g003.jpg
case_images: F3
case_images: A Toupet fundoplication has been added as an antireflux procedure, with stitches placed at esophago-cardiomyotomy s edges (Figure 3).