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Relationship Between Diffuse Esophageal Spasm and Lower Esophageal Sphincter Dysfunction on Barium Studies and Manometry in 14 Patients

Anand Prabhakar1, Marc S. Levine1, Stephen Rubesin1, Igor Laufer1 and David Katzka2

1 Department of Radiology, Hospital of the University of Pennsylvania, 3400 Spruce St., Philadelphia, PA 19104.
2 Department of Medicine, Hospital of the University of Pennsylvania, Philadelphia, PA 19104.



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  		Fig. 1. —74-year-old man with diffuse esophageal spasm who presented with dysphagia. Prone right anterior oblique view from single-contrast esophagram shows multiple nonperistaltic contractions (arrows) of moderate severity without classic corkscrew appearance. Lower esophageal sphincter opened normally.

 


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  		Fig. 2. —78-year-old woman with diffuse esophageal spasm who presented with dysphagia. Prone right anterior oblique view from single-contrast esophagram shows multiple lumen-obliterating nonperistaltic contractions (white arrows), producing corkscrew appearance. Note small hiatal hernia (black arrow).

 


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  		Fig. 3. —74-year-old woman with diffuse esophageal spasm who presented with dysphagia. Prone right anterior oblique view from single-contrast esophagram shows nearly lumen-obliterating nonperistaltic contractions (straight white arrows) with tapered, beaklike narrowing (black arrow) of distal esophagus near gastroesophageal junction secondary to incomplete opening of lower esophageal sphincter. Hiatal hernia (curved white arrow) is also visible.

 

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