Click on Images for Enlarged View
Findings: The esophagus, stomach, and duodenum showed no evidence of abnormality until the patient was placed in the supine position in the right posterior oblique and asked to swallow plain water after she had ingested barium. Upon straining, free reflux of the opaque barium was seen into the distal and mid esophagus with visualization of a hiatal hernia and non-obstructing Schatzki Ring.
Diagnosis: Free esophageal reflux with demonstration of hiatal hernia and Schatzki Ring by means of the so-called water siphonage test.
References:
Rohrmann CA, Jr. When is a Schatzki Ring Clinically Significant,
and What is the Best Maneuver to Demonstrate it on Barium Swallow?
Does the Abnormality Progress if it is Not Treated? AJR 1994;163(1):215.
Johnson AC, Lester PD, Johnson S, Sudarsanam D, Dunn D. Esophagogastric Ring:
Why and When we See, and What it Implies: A Radiologic-Pathologic Correlation.
(Review). Southern Medical Journal 1992;85(10):946-952.
Thompson JK, Koehler RE, Richter JE. Detection of Gastroesophageal Reflux:
Value of Barium Studies Compared with 24-hr. pH Monitoring (see comments).
AJR 1994;162(3):621-626.
Submitted by: