Two pediatric type II achalasia cases complicated by candidal and eosinophilic esophagitis: Successful peroral endoscopic myotomy treatment.

Achalasia is a rare esophageal motility disorder in children, often leading to delayed diagnosis. We report the first two pediatric cases treated with peroral endoscopic myotomy (POEM) at our center, both classified as type II achalasia and complicated by mucosal disease. A 15-year-old girl presented with progressive dysphagia and weight loss, diagnosed with type II achalasia and Candida esophagitis. A 13-year-old boy exhibited similar symptoms with a 27-kg weight loss; histology revealed concurrent eosinophilic esophagitis. Both underwent successful POEM. These cases illustrate the clinical heterogeneity of pediatric achalasia and emphasize the importance of recognizing concomitant mucosal conditions that may delay diagnosis. POEM appears to be a safe and effective, minimally invasive treatment in the pediatric population, even in complex scenarios.