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Figure 1. 82-year-old man with transient failure of opening of lower oesophageal sphincter (LOS) on upright oesophagram. This patient had no history of dysphagia. (a) Initial double-contrast view of oesophagus in upright, left posterior oblique position shows tapered, beaklike narrowing (arrow) of distal oesophagus secondary to failure of opening of LOS. Note proximal dilatation of oesophagus and absence of barium in stomach. (b) Subsequent single-contrast view of oesophagus in prone, right anterior oblique position shows normal-appearing distal oesophagus with normal opening of LOS. This patient also has a small hiatal hernia (arrow).
