A 32-year-old man was diagnosed with esophageal achalasia and treated with Ca antagonist as an outpatient. A reflux symptom that developed after a meal sometime from November, 2002, was gradually worse, and he was admitted for treatment with balloon dilatation on July 4, 2003. We performed esophageal dilatation with a Rigiflex ABD Achalasia Balloon Dilator (Boston Scientific, Tokyo, Japan) , using a low-compliance balloon to achieve a 3cm-diameter of dilatation on the same day. According to the previous reports, this dilatation method and surgical method revealed equal efficacy in the treatment. We expanded the balloon in 10psi for three minutes and performed dilatation under the same condition twice. Marked improvement of clinical symptom was obtained on the next day. He had no serious complications such esophageal perforation and was discharged on July 7. At the time of this report the symptom had not recurred, and he continues to be followed-up as an outpatient. We suggest that balloon dilatation therapy should be treatment of choice next to medication in the management of esophageal achalasia.
