Oesophageal achalasia presents with acute stridor in the Emergency Department

Oesophageal achalasia is a condition of unknown aetiology that most commonly presents with dysphagia, oesophageal regurgitation or chest pain. A case is described of an 88-year-old lady who presented to the Emergency Department with acute stridor as the initial presentation of oesophageal achalasia. Key steps in management included prompt involvement of an appropriate multi-disciplinary team, control of the compromised airway and early decompression of the mega oesophagus. Our report particularly highlights the diagnostic challenges faced by clinicians dealing with this medical emergency. We recommend that a diagnosis of achalasia should be considered as part of the differential diagnosis in a patient who presents with acute stridor.