Case contributed by Kenny Sim


Chest pain.

Patient Data

Age: 65 years
Gender: Female



The esophagus is grossly dilated and measures up to 10 cm in diameter. There are two air-fluid levels projected at the level of the posterior third rib. The gastric bubble is however present. These findings are in keeping with achalasia.

The aortic arch and descending thoracic aorta are unremarkable.

The lungs are clear with no evidence of aspiration.

Case Discussion

Achalasia appears at chest radiograph as a convex opacity overlapping the right mediastinum. Air-fluid levels could be present due to stasis of oesophagal contents.

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