An Unusal Achalasic Sigmoid Esophagus

Abstract

A 24 year old female presented to our OPD with chief complaints of difficulty to swallow solids & liquids, regurgitation , nocturnal cough & recurrent chest infections.These complaints existed from the age when she was just 10 years old & as per the patient she underwent endoscopy  twice that time & some endoscopic procedure , which she was neither  able to recall nor any records were available.As per her, she had difficulty in swallowing solids & liquids that time also & which improved after those endoscopic procedures.The above mentioned symptoms started again around two years back with progession of these symptoms over the period of time. She ignored these symptoms & started taking lesser meals( even skipping meals at times to avoid these symptoms) which had led to a significant weight loss of around 10 kg over these two years.The patient denied any history of bleeding from mouth or per anum or fever . Also , on further questioning patient gave significant history of regurgitating food items which were taken 2-3 days back.history of halitosis was also given by the patient.On examination ,