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Figure 4-20 Single-contrast esophagogram in a 12-year-old boy complaining of dysphagia after a large meal. There is minimal dilatation of the upper and midesophagus with an abrupt change in caliber in the distal esophagus (arrows), compatible with food impaction. Only minimal contrast trickles through the obstruction into the stomach. Endoscopy was necessary for removal of the impacted meat. An infiltrating esophageal carcinoma could have a similar appearance.

Figure 4-21 Contrast upper GI series in a patient with Boerhaave's syndrome demonstrates free extravasated contrast into the mediastinum adjacent to the esophagus. (From Jones, B., and Braver, J.M. (eds.): Essentials of Gastrointestinal Radiology. Philadelphia, W.B. Saunders, 1982.)

Figure 4-22 Single-contrast esophagogram demonstrates diffuse esophageal spasm. Spasm can result in partial or complete obliteration of the esophageal lumen. This can result in pseudodiverticula between adjacent areas of spasm. (From von Heuck, F.: Klinische Radiologie Diagnotik mit bildgebenden Verfahren. In von Fuchs, H.-F., and Donner, M. W. feds.]: Gastrointestinaltrakt Berlin, Springer-Verlag, 1990.)

Figure 4-23 Single-contrast esophagogram in a patient with achalasia demonstrates the characteristic tapering of the distal esophagus. This is referred to as a "bird's beak."

Figure 4-24 Double-contrast esophagogram demonstrates a 1.5 cm smooth intramural (submucosal) mass (arrow) in the upper esophagus, compatible with a leiomyoma. (From von Heuck, F.: Klinische Radiologie Diagnotik mit bildgebenden Verfahren. In von Fuchs, H.-F., and Donner, M.W. [eds.]: Gastrointestinaltrakt. Berlin, Springer-Verlag, 1990.)

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