tertiary esophageal contractions

disordered up-and-down movement of bolus
• 5-10% of normal adults in 4-6th decade
• location: distal 2/3 of esophagus

• presbyesophagus
• diffuse esophageal spasm
• hyperactive achalasia
• neuromuscular disease: diabetes, Parkinsonism, ALS, MS, thyrotoxic myopathy, myotonic dystrophy
• obstruction of cardia: neoplasm, distal esophageal stricture, benign lesion, surgery (repair of HH)

• spontaneous repetitive nonpropulsive contraction ("yo-yo" motion)
• "corkscrew" appearance
• compartmentalization of barium ("rosary bead", "shish kebab")

© 2002, C.E. Kahn, Jr.
2002-04-18