A patient suffering from achalasia was treated by esophagotomy. Severe esophagitis was produced. The patient was reoperated and an extended esophagomyotomy and anterior fundoplication was performed. Esophagitis and peptic stenosis was demonstrated. Because of the ineffectiveness of previous medical treatment, a new surgical approach was performed - the short Nissen fundoplasty. As the stenosis continued , the patient was reevaluated and more surgical treatment was indicated. The esophagus was fibrotic and almost destroyed. Resection of the lower third (transhiatal) was done. Reconstruction was performed by means of an isolated jejunal loop interposed between esophagus and stomach.