A corkscrew-shaped esophagus

Endoscopy is an excellent tool in the diagnosis of mucosal lesions. Unfortunately, it cannot differentiate between normal and abnormal peristalsis and hence is insensitive in the diagnosis of motility disorders of the esophagus. This figure depicts the esophagogram of a patient with dysphagia and chest pain. His endoscopy is completely normal. Esophagogram shows classic changes of diffuse esophageal spasm, with a corkscrew-shaped ‌ esophagus. Esophageal manometry confirms the diagnosis.