Presentation
Recurrent chest infections.
Patient Data
Age: 15 years
Gender: Female
From the case:
Achalasia
Frontal

There are prominent perihilar interstitial markings and patchy airspace opacification.
From the case:
Achalasia
Axial lung window

Grossly distended esophagus contains a large amount of food debris. There are numerous small foci of airspace and groundglass opacification. Given the appearance of the esophagus, the lung changes most likely reflect aspiration.
From the case:
Achalasia

Distended esophagus and bird beak appearance of the esophageal sphincter, in a pattern typical of achalasia.
Case Discussion
Typical fluoroscopic appearance of achalasia, with secondary aspiration seen on chest imaging.