Abstract
Objective: To describe the presentation, evolution and outcome of a case of achalasia of idiopathic origin that is difficult to diagnose treated by laparoscopy. Case details: A 44-year-old female patient with a report of chest pain and difficulty swallowing for four years, as well as significant weight loss over the years. It was initially diagnosed and treated for moderate gastritis after diagnostic investigation with upper digestive endoscopy. Due to the persistence of symptoms and a new investigation, the suspicion of achalasia was raised after endoscopy and contrasted radiographic examination, later confirmed by manometry and corrected by cardiomyotomy to Heller and subsequent valvuloplasty to Toupet, evolving without complications. Final considerations: Esophageal achalasia is known as a primary esophageal motor disorder that has been studied for a long time, is rare and has an idiopathic predominance in the world. In most cases, dysphagia is the predominant symptom, in addition to the occurrence of emesis, chest pain and a feeling of impaction of the bolus, which makes weight loss frequent during the course of the disease. The therapeutic approach with the greatest reduction in patients' morbidity and mortality is the laparoscopic technique, with less intraoperative complications, shorter hospital stay and better recovery.