Surgical treatment of nutcracker esophagus

The "nutcracker esophagus" has become a commonly diagnosed esophageal motility disorder due to the advent of the more accurate low-compliance perfusion system. The disorder is characterized by high-amplitude peristaltic contractions often of prolonged duration and manifested by dysphagia and chest pain. Typically, symptomatic control is achieved with medical management. We report a case of "nutcracker esophagus" that was refractory to conventional modes of treatment but responded with symptomatic and manometric resolution after an extended esophagomyotomy.