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Fig. 3 —45-year-old woman with diffuse esophageal spasm after laparoscopic Nissen fundoplication. Upright, left posterior oblique view from single-contrast upper gastrointestinal tract examination shows numerous mild to moderate nonperistaltic contractions (arrows) in lower thoracic esophagus. There also was intermittent absence of primary peristalsis at fluoroscopy. Although no lumenobliterating contractions were observed, these findings are compatible with diffuse esophageal spasm.