Heller's cardiomyotomy after failed pneumatic dilatation for achalasia cardia--operative pitfalls.

A female aged 46, with achalasia cardia had no relief of dysphagia after pneumatic dilatation done twice. At surgery the muscle fibres were found disrupted, with submucosal adhesions and friable mucosa. Heller's cardiomyotomy could not be done. Repair similar to Mickulicz pyloroplasty was done.