Radiology (Reflux)

Esophagogastrography in a patient with gastroesophageal reflux prior to and after surgery. In the picture at the top the esophagus remains filled with contrast which is not true in the picture at the bottom. A gastroesophageal reflux can only be suspected due to chronic vomiting or in case of complicated reflux due to the correspondig leading symptoms. For the visualization of a gastroesophageal reflux an esophagogastrography with fluoroscopy is necessary. This examination of the presented case shows a spontaneous reflux of contrast from the already filled stomach into the esophagus. Broad folds of the mucosa run beyond the limit of the diaphragm into the mediastinum in the direction of the esophagus which is an anatomical correlate to the observed reflux; therefore, at least temporary small parts of the fundus herniate into the thorax during the examination; in addition, there is an obtuse angle of His between cardia and fundus. Following surgery the gastroesophageal transition is closing normally, and the angle is acute. There is a small jet of contrast visible within a heart-shaped defect of contrast which corresponds to the sleeve of fundus around the abdominal esophagus.