Infantile achalasia in Down's Syndrome

A 3-year old girl with clinical features of Down's syndrome presented with persistent vomiting of undigested food and recurrent cough. Although her karyotype was not carried out; radiographs of the pelvis and hands revealed characteristic features of Down's syndrome. An investigative barium swallow to diagnose the cause of the vomiting showed achalasia which is a rare association with Down's syndrome