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Figure 2


Fig. 2 49-year-old man with secondary achalasia after laparoscopic Nissen fundoplication. Prone, right anterior oblique view from double-contrast upper gastrointestinal tract examination shows mildly dilated esophagus with beaklike narrowing (black arrow) of distal esophagus near gastroesophageal junction. There was no evidence of primary peristalsis at fluoroscopy. Note surrounding wrap (white arrows) from Nissen fundoplication, which made it difficult to assess lower esophageal sphincter opening.





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