Gastrointestinal Tract

Major conditions associated with esophageal motor dysfunction

Achalasia esophagus
In patients with achalasia, the valve between the esophagus and stomach fails to open properly during eating. In addition, the muscles of the esophagus don't effectively propel food into the stomach.


Achalasia. Inability to relax lower esophageal sphincter leads to massive esophageal dilation
Achalasia esophagus

Achalasia Dorsal view with the massively dilated esophagus opened longitudinally.

Achalasia esophagus

Sliding hiatal hernia

In a sliding hiatal hernia, part of the stomach moves through the diaphragm so that it is positioned outside of the abdomen and in the chest. The lower esophageal sphincter (LES) often moves up above its normal location in the opening of the diaphragm.

Hiatal hernia paraeosphgeal & mixed

In a paraesophageal hernia, the stomach bulges up through the opening in the diaphragm (hiatus) alongside the esophagus (upside-down stomach). The LES remains in its normal location inside the opening of the diaphragm. This type of hernia most commonly occurs when there is a large opening in the diaphragm next to the esophagus. The stomach and, rarely, other abdominal organs (such as the intestine, spleen, and colon) may also bulge into the chest in a paraesophageal hernia. MIXED HERNIA in a mixed hiatal hernia, the LES is above the diaphragm as in a sliding hiatal hernia, and the stomach is alongside the esophagus as in a paraesophageal hiatal hernia.


Hiatal hernia
A hiatal hernia is the protrusion of abdominal viscera, usually the stomach, into the thoracic cavity due to a weakness in the region of the esophageal hiatus of the diaphragm. Two examples are shown above.

Diverticulum esophagus

Zenker’s Diverticulum Midesophageal Diverticulum
Epiphrenic Diverticulum

Zenker Diverticulum

Focal out pouching of the upper esophagus wall that contains all or some of its constituents

Mallory-Weiss tear

This is a tear in the mucosal layer at the junction of the esophagus and stomach
Image demonstrates a thin, linear tear (arrow) beginning just above the squamocolumnar junction and extending proximally.

Esophageal lacerations (Mallory-Weiss syndrome)

Gross photograph demonstrating longitudinal lacerations oriented in the axis of the esophageal lumen (arrow), extending from the esophageal mucosa to the stomach mucosa.
Esophageal mucosa
Gastric mucosa