{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T15:35:30Z","timestamp":1792510530324,"version":"4.5.0"},"reference-count":11,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2017,4,9]],"date-time":"2017-04-09T00:00:00Z","timestamp":1491696000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Neurogastroenterology Motil"],"published-print":{"date-parts":[[2017,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Esophagogastric junction (<jats:styled-content style=\"fixed-case\">EGJ<\/jats:styled-content>) outflow obstruction (<jats:styled-content style=\"fixed-case\">EGJOO<\/jats:styled-content>) is characterized by impaired <jats:styled-content style=\"fixed-case\">EGJ<\/jats:styled-content> relaxation with intact or weak peristalsis. Our aims were to evaluate: (i) prevalence, (ii) yield of fluoroscopy, endoscopy, and endoscopic ultrasound (<jats:styled-content style=\"fixed-case\">EUS<\/jats:styled-content>), (iii) outcomes, and (iv) whether this data differed based on quantitative <jats:styled-content style=\"fixed-case\">EGJ<\/jats:styled-content> relaxation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Studies that met criteria for <jats:styled-content style=\"fixed-case\">EGJOO<\/jats:styled-content> were identified. Demographics, encounters, endoscopy, radiology, treatment decisions, and outcomes were extracted.<\/jats:p><\/jats:sec><jats:sec><jats:title>Key Results<\/jats:title><jats:p>Sixty studies were identified. Dysphagia was the most common symptom. Forty patients underwent barium esophagram (<jats:styled-content style=\"fixed-case\">BE<\/jats:styled-content>): normal (11), hiatal hernia (20), spasm\/dysmotility (17), <jats:styled-content style=\"fixed-case\">EGJ<\/jats:styled-content> narrowing (10), compression (2), Schatzki's ring (5), malrotation (1), gastric volvulus (1), mass (1). Esophagogastroduodenoscopy (<jats:styled-content style=\"fixed-case\">EGD<\/jats:styled-content>) was performed in 41 patients: normal (19), hiatal hernia (13), Schatzki's ring (6), esophagitis (3), esophageal candidiasis (3), mass (1). <jats:styled-content style=\"fixed-case\">EUS<\/jats:styled-content> was performed in 20 patients and was frequently normal. Twenty\u2010two patients underwent intervention. While transient improvement was noted in the majority, persistent improvement was seen in only one of nine patients (dilatation), four of six patients (botulinum toxin), and three patients who underwent per\u2010oral endoscopic myotomy. No patients treated with medical therapy alone had improvement in dysphagia. There was no difference in symptoms or outcomes based on quantitative <jats:styled-content style=\"fixed-case\">EGJ<\/jats:styled-content> relaxation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions &amp; Inferences<\/jats:title><jats:p>The manometric criterion <jats:styled-content style=\"fixed-case\">EGJOO<\/jats:styled-content> defines a heterogeneous clinical group. While <jats:styled-content style=\"fixed-case\">BE<\/jats:styled-content>,<jats:styled-content style=\"fixed-case\"> EGD<\/jats:styled-content>, and <jats:styled-content style=\"fixed-case\">EUS<\/jats:styled-content> all provide complementary information, a significant percentage of these studies will be normal. For patients with dysphagia, outcome may depend on <jats:styled-content style=\"fixed-case\">EGJ<\/jats:styled-content> disruption. There were no differences in symptoms our outcomes based on quantitative <jats:styled-content style=\"fixed-case\">EGJ<\/jats:styled-content> relaxation.<\/jats:p><\/jats:sec>","DOI":"10.1111\/nmo.13061","type":"journal-article","created":{"date-parts":[[2017,4,10]],"date-time":"2017-04-10T03:42:41Z","timestamp":1491795761000},"source":"Crossref","is-referenced-by-count":77,"title":["What is the clinical significance of esophagogastric junction outflow obstruction? evaluation of 60 patients at a tertiary referral center"],"prefix":"10.1111","volume":"29","author":[{"given":"F. C.","family":"Okeke","sequence":"first","affiliation":[{"name":"Division of Hospital Medicine The Johns Hopkins University School of Medicine  Baltimore MD USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S.","family":"Raja","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology &amp; Hepatology Emory University School of Medicine  Atlanta GA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"K. L.","family":"Lynch","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology &amp; Hepatology University of Pennsylvania School of Medicine  Philadelphia PA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S.","family":"Dhalla","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology &amp; Hepatology The Johns Hopkins University School of Medicine  Baltimore MD USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Nandwani","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology &amp; Hepatology Stanford University School of Medicine  Stanford CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E. M.","family":"Stein","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology &amp; Hepatology The Johns Hopkins University School of Medicine  Baltimore MD USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"B.","family":"Chander Roland","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology &amp; Hepatology The Johns Hopkins University School of Medicine  Baltimore MD USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M. A.","family":"Khashab","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology &amp; Hepatology The Johns Hopkins University School of Medicine  Baltimore MD USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P.","family":"Saxena","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology &amp; Hepatology The Johns Hopkins University School of Medicine  Baltimore MD USA"},{"name":"Division of Gastroenterology Royal Prince Alfred Hospital  Sydney NSW Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"V.","family":"Kumbhari","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology &amp; Hepatology The Johns Hopkins University School of Medicine  Baltimore MD USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"N. K.","family":"Ahuja","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology &amp; Hepatology The Johns Hopkins University School of Medicine  Baltimore MD USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2625-1169","authenticated-orcid":false,"given":"J. 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