CTICasesAchalasia with Aspiration Pneumonia
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Imaging findings
Bilateral, multi-lobar, focal, sub-segmental opacities in both lungs (aspiration pneumonia). An additional collection of air or an air-containing structure in the superior mediastinum adjacent to the trachea, representing a very distended esophagus with ingested material and air. Follow-up shows resolution of lung opacities.
Key takeaways
Classic radiographic findings of achalasia (distended air-filled esophagus with food debris, superior mediastinal air collection) associated with recurrent aspiration pneumonia. Recognition of these subtle findings on chest radiographs can guide diagnosis of the underlying esophageal pathology.
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