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This case report aims to describe chronic esophageal dysphagia in a patient from an endemic area in northeastern Brazil, highlighting diagnostic and therapeutic challenges within the public health system, including delays due to COVID\u201019 restrictions and resource limitations. A 67\u2010year\u2010old female from Rio Grande do Norte, with prior Chagas disease diagnosis (2004, etiologically treated), hypertension, and dyslipidemia, presented in 2019 with solid\u2010food dysphagia and nocturnal regurgitation. Initial tests (chest X\u2010ray, ECG, and echocardiography) were normal, but contrast studies (barium esophagogram, and colon) were delayed until 2022, revealing 7\u2009cm esophageal dilation (Rezende Group III), cardia narrowing, and retained contrast\/food residues. Symptoms worsened, with a 5\u2009kg weight loss and liquid\u2010only diet. Videolaparoscopic Heller\u2013Pinotti cardiomyotomy was performed in September 2023 after clinical optimization (isosorbide dinitrate and domperidone). The 2\u2009h procedure was uneventful; discharge occurred within 24\u2009h on zero diet, progressing to normal intake by 5\u2009weeks. By February 2024, she was asymptomatic, with a 2\u2009kg weight gain (from 66\u2009kg). This case confirms laparoscopic cardiomyotomy\u2019s efficacy (90% success in Rezende I\u2013III) for symptom resolution in nonadvanced chagasic megaesophagus. Public health insights underscore Chagas underreporting, late diagnosis, and public health system barriers in vulnerable populations, advocating early serological screening and etiological treatment in acute phases to prevent chronic digestive forms in endemic regions.<\/jats:p>","DOI":"10.1155\/crdi\/9930462","type":"journal-article","created":{"date-parts":[[2026,4,22]],"date-time":"2026-04-22T07:50:51Z","timestamp":1776844251000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Chagasic Esophagopathy With Achalasia and Megaesophagus: A Case Report"],"prefix":"10.1155","volume":"2026","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0879-3012","authenticated-orcid":false,"given":"Gabriel Xerez de","family":"Oliveira","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-3013-2338","authenticated-orcid":false,"given":"Beatriz Lacerda","family":"Bezerra","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7965-3095","authenticated-orcid":false,"given":"Jos\u00e9 Antonio da","family":"Silva J\u00fanior","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4014-6242","authenticated-orcid":false,"given":"Ellany Gurgel Cosme do","family":"Nascimento","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0264-8842","authenticated-orcid":false,"given":"Cl\u00e9ber de Mesquita","family":"Andrade","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2026,4,22]]},"reference":[{"key":"e_1_2_9_1_2","doi-asserted-by":"crossref","DOI":"10.1016\/S1473-3099(01)00065-2","article-title":"Clinical and Epidemiological Aspects of Chagas Disease","author":"Prata A.","year":"2001","journal-title":"The Lancet Infectious Diseases"},{"key":"e_1_2_9_2_2","doi-asserted-by":"publisher","DOI":"10.36660\/abc.20230269"},{"key":"e_1_2_9_3_2","first-page":"238","volume-title":"Can\u00e7ado JR. 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