Barium was administered via baby's feeding bottle. It flowed slowly to opacify a dilated oesophagus. There were no appreciable oesophageal contractions, resulting in slow transit of barium to the stomach with an apparent tapering distally (bird beak sign) and at the oesophagogastric junction. Appearances are most in keeping with achalasia. Note thymic silhouette on the left side of chest.