Mycostatin will be helpful in candidal esophagitis, whereas herpetic esophagitis often is self-limiting FIGURE 56.3 Upper gastrointestinal (UGI) series of a 14-year-old girl presenting with dysphagia The UGI demonstrates a significantly dilated upper esophagus, with a functional spasmodic obstruction of the lower esophagus, characteristic of achalasia Pediatric dysphagia is an uncommon complaint in the pediatric emergency department but may be the presenting symptom for a wide variety of underlying clinical problems The history and physical examination first must focus on potentially life-threatening causes and will often lead to a specific diagnosis