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Fig. 1 —45-year-old man with secondary achalasia after laparoscopic
Nissen fundoplication. Upright, left posterior oblique view from
single-contrast upper gastrointestinal tract examination shows dilated
esophagus with tapered, beaklike narrowing (black arrow) adjacent to
gastroesophageal junction and delayed emptying of barium into stomach. There
was no evidence of primary peristalsis at fluoroscopy. Clips (white
arrows) are seen near gastroesophageal junction from recent
fundoplication. Note dilution of barium by fluid in dilated esophagus more
proximally.
