Paraoesophageal hernia causing recurrent dysphagia after Heller myotomy in achalasia.

A woman in her 60s with a medical history of achalasia treated by laparoscopic Heller myotomy presented with recurrent dysphagia 10 years postsurgery. This persistent symptom was initially suspected to be due to a rare recurrence of achalasia. However, a large paraoesophageal hernia was unexpectedly found during the upper gastrointestinal series. The patient underwent laparoscopic exploration, during which the integrity of the prior Heller myotomy was confirmed, and the paraoesophageal hernia was successfully reduced. Following the intervention, the patient's symptoms completely resolved, highlighting the importance of considering structural abnormalities in patients with oesophageal motility disorders.