Chest pain, regurgitating food, pneumonitis (93/1700)

A 48yo woman is admitted to ED with a productive cough and moderate fever. She has often
central chest pain and regurgitation of undigested food most times but doesn’t suffer from acid
reflux. These symptoms have been present for the last 3.5 months which affects both food and
drink. A CXR shows an air-fluid level behind a normal sized heart. What is the most likely dx?
a. Pharyngeal pouch
b. Hiatus hernia
c. Bulbar palsy
d. Achalasia
e. TB
































answer D