A 75 year-old female, who 3 months ago had started with weight loss and persiting vomiting. A forceful maneuvering of the endoscope had to be done, in order to overcome the sphincter. The incidence of achalasia is approximately 1 per 100,000 people per year. Chagas disease may cause a similar disorder due to Trypanosoma Cruzi. The exact cause of achalasia is unknown.
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