Background and study aims Childhood achalasia treatment remains inconclusive. What is next after myotomy failure. Repeated pneumatic-dilation put patients at greater risk of perforation with possible symptom recurrence. We report on a 12-year-old patient with a 1-year history of achalasia whom underwent Heller myotomy with fundoplication and recurred with symptoms 1 week after surgery. https://www.lightemupsequences.com/