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The oesophagus is grossly dilated and measures up to 10 cm in diameter. There is an air fluid level projected at the level of the posterior third rib. These findings are in keeping with the known history of achalasia. There is displacement of the trachea to the right with significant narrowing of the trachea, best appreciated in the lateral projection.
This is primary achalasia in this patient. CT and barium swallow showed no evidence of extrinsic compression of the distal oesophagus.