Esophageal obstruction secondary to a partially volvulated paraesophageal gastric herniation

The first four slides of the fluoroscopy  show the primary peristaltic wave (triggered by the swallowing center)   and t he secondary peristaltic wave  (induced by esophageal distension)   to clear the esophagus of retained baritated- contrast agent .  The result of the multiple esophageal peristaltic waves was a threadlike flow through the entrance of the gastric hernia.

The last two slides show the tertiary contractions (dysfunctional contractions). These contractions are nonperistaltic and are observed with increased frequency in elderly people.

Here we have a previously performed CT due to abdominal discomfort. 

We observe the large gastric hernia partially included in this study.