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Diffuse Esophageal Spasm: Clinical, Radiological, and Manometric Observations

Ann Intern Med. 1964;61(5_Part_1):914-923. doi:10.7326/0003-4819-61-5-914
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Tertiary contractions, a series of irregular indentations in the margin of the barium-filled esophagus, are commonly seen during X-ray examination, particularly in elderly people (1). Unlike peristaltic waves, tertiary contractions remain localized and do not progress distally. The degree of distortion of the esophageal contour varies, and a number of descriptive names have been applied such as corkscrew esophagus, multiple pseudodiverticulosis, and rosary-bead esophagus (2). This condition usually has been considered to be of no clinical significance (3, 4). A few reports, however, associated these radiologic abnormalities with dysphagia and substernal pain (5-8). The clinical syndrome has been called diffuse


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