Diffuse Esophageal Spasm
Authors: HAROLD P. ROTH
Journal: Annals of Internal Medicine (1964)

Article1 November 1964Diffuse Esophageal SpasmClinical, Radiological, and Manometric ObservationsHAROLD P. ROTH, M.D., F.A.C.P., BERTRAM FLESHLER, M.D., F.A.C.P.HAROLD P. ROTH, M.D., F.A.C.P.Search for more papers by this author, BERTRAM FLESHLER, M.D., F.A.C.P.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-61-5-914 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTertiary 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...References1. TEMPLETON FE: X-ray Examination of the Stomach: A Description of the Roentgenologic Anatomy, Physiology, and Pathology of the Esophagus, Stomach, and Duodenum, University of Chicago Press, Chicago, 1944, pp. 457-463. Google Scholar2. KRAMERFLESHLERMCNALLY PBE: The pathophysiology of symptomatic "curling" or so-called "diffuse spasm," in Proceedings of the Second World Congress of Gastroenterology, 1962, S. Karger, Basle and New York, 1963, Vol. I, pp. 57-59. Google Scholar3. GOLDEN R: Diagnostic Roentgenology, Thomas Nelson and Sons, New York, 1948, Vol. I, pp. 272-275. Google Scholar4. BOCKUS HB: Gastroenterology, Second Edition, W. B. Saunders, 1963, pp. 55-57, 121-122. Google Scholar5. MOERSCHCAMP HJJD: Diffuse spasm of the lower part of the esophagus. Ann. Otol. 43: 1165, 1934. Google Scholar6. CRICHLOWSHAW TVHJ: Abnormal ring contractions of the thoracic oesophagus. Brit. J. Surg. 42: 46, 1954. CrossrefMedlineGoogle Scholar7. SCHMIDT HW: Diffuse spasm of the lower half of the esophagus. Amer. J. Dig. Dis. 6: 693, 1939. CrossrefGoogle Scholar8. ISMAY G: Painful spasm of the oesophagus ("corkscrew" oesophagus). Brit. Med. J. 2: 697, 1952. CrossrefMedlineGoogle Scholar9. CREAMERDONOGHUECODE BFEDF: Pattern of esophageal motility in diffuse spasm. Gastroenterology 34: 782, 1958. CrossrefMedlineGoogle Scholar10. NAGLERSPIRO RHM: Serial esophageal motility studies in asymptomatic young subjects. Gastroenterology 41: 371, 1961. CrossrefMedlineGoogle Scholar11. SIEGEL S: Nonparametric Statistics, McGraw Hill Book Co. Inc., New York, 1956, pp. 116-127. Google Scholar12. CODECREAMERSCHLEGELOLSENDONOGHUEANDERSEN CBJAFH: An Atlas of Esophageal Motility in Health and Disease, Charles C. Thomas Publisher, Springfield, pp. 86-107. Google Scholar13. INGELFINGER FJ: Esophageal motility. Physiol. Rev. 38: 533, 1958. CrossrefMedlineGoogle Scholar14. OLSENCODECLAGETT ACO: Role of motility patterns in the diagnosis of esophageal disease. JAMA 172: 319, 1960. CrossrefMedlineGoogle Scholar15. CROSSKAYJOHNSON FSEBGF: Studies on neuromuscular imbalance of the esophagus. Arch. Surg. (Chicago) 75: 631, 1957. Google Scholar16. ESKRIDGEPEAKE MJD: Curling of the esophagus. Southern Med. J. 46: 213, 1953. CrossrefMedlineGoogle Scholar17. ELLISCODEOLSEN FCA: Long esophagomyotomy for diffuse spasm of the esophagus and hypertensive gastroesophageal sphincter. Surgery 48: 155, 1960. MedlineGoogle Scholar18. LERCHE W: The esophagus and pharynx in action, Charles C Thomas Publisher, Springfield, 1950, pp. 82-87. Google Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Cleveland, OhioFrom the Department of Medicine, Western Reserve University School of Medicine, and the Medical Services of the Veterans Administration Hospital and Metropolitan General Hospital, Cleveland, Ohio.Presented in part at the First Sectional Meeting (Midwest) of the American College of Physicians, Detroit, Mich., Nov. 21-23, 1963.Requests for reprints should be addressed to Harold P. Roth, M.D., Veterans Administration Hospital, 10701 East Blvd., Cleveland, Ohio 44106. 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