Answer : Achalasia Cardia
Failure of organized peristalsis with impaired relaxation at the level of lower esophageal sphincter often marked dilatation of the oesophagus and food stasis.
CXR :
Right convex opacitybehind right cardiac border.
Air-fluid level due to statis in thoracic oesophagus filled with retained secretions and food
Small/absent gastric air bubble.
Barium :
Assess for mucosal abnormalities also
Findings include:
Failure of normal peristalsis to clear the oesophagus of barium when the patient is in the recumbent position, with no primary waves identified.
Uncoordinated, non-propulsive, teritary contractions
oesophageal body dilatation, which is typically maximal in the distal esophagus
pooling or stasis of barium in the oesophagus when the oesophagus has become atonic or non contractile (late feature in the disease)
Bird Beak Sign