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Fig. 4. —87-year-old woman with secondary achalasia caused by carcinoma of uterus. Spot radiograph from double-contrast barium study shows 4-cm-long smooth, tapered narrowing (arrows) of distal esophagus with esophageal diameter proximally of 3.5 cm. As in Figure 3, a narrowed segment longer than 3.5 cm should be considered highly suggestive of secondary achalasia, even lacking other suspicious radiographic findings.





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