There is displacement of the azygoesophageal line both superiorly an inferiorly.
There is an air-fluid level (arrow).
Combined with the above this must be a dilated esophagus with residual fluid. The final diagnosis was achalasia.
The density on the left in the region of the lingula is the result from prior aspiration pneumonia. #Clinical #Radiology #CXR #Achalasia #DilatedEsophagus #AirFluidLevel #Aspiration #RadiologyAssistant