Low Yield of Cross-Sectional Imaging in Patients With Esophagogastric Junction Outflow Obstruction

Esophagogastric junction outflow obstruction (EGJOO) is an abnormal finding on high-resolution manometry (HRM) characterized by an elevated median integrated relaxation pressure with some intact peristalsis.¹ EGJOO is associated with heterogeneous symptoms, disease course, and response to treatment.^1-4 It can be idiopathic or secondary with causes including malignancy, infiltrative disease, or structural etiology.^1,3 Therefore, Chicago Classification of Esophageal Motility Disorders version 3.0 (CC v3.0) states a finding of EGJOO should prompt further investigation with cross-sectional imaging (CSI): endoscopic ultrasound (EUS) or computed tomography (CT) scan. However, there are limited data on the added yield of CSI to conventional modalities, namely esophagogastroduodenoscopy (EGD) and barium esophagram (BE). In previous studies, yield was small or unspecified.^2,5-8 The aim of this study was to examine the yield of CSI for diagnosing secondary causes of EGJOO.