The neuromotor disorders of the oesophagus are rare in childhood. The spectrum includes achalasia, vigorous achalasia and diffuse oesophageal spasm. The classical presentation in achalasia is vomiting, failure to thrive and recurrent chest infection. Diagnosis is confirmed on plain film of the chest and a barium swallow which shows the "bird beak" sign. Surgery is the preferred mode of management in children. Adjunctive procedures to surgery like Nissen fundoplication should be selectively performed.
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