{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T18:55:54Z","timestamp":1793386554663,"version":"4.5.0"},"reference-count":35,"publisher":"MDPI AG","issue":"17","license":[{"start":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T00:00:00Z","timestamp":1787788800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Introduction: Esophagogastric junction outflow obstruction (EGJOO) is a heterogeneous manometric pattern requiring symptoms and supportive evidence to establish clinical relevance. Timed barium esophagography (TBE) provides functional radiologic assessment of esophageal emptying through timed imaging, quantitative barium column measurements, and morphologic evaluation. Methods: This single-center retrospective study included 42 patients referred for TBE for suspected EGJOO between June 2024 and December 2025. TBE was performed upright after ingestion of low-density barium suspension. Positivity required a continuous residual esophageal barium column with craniocaudal height \u2265 2 mm at 1\u2032 after bolus ingestion. Minimal mucosal coating, non-columnar traces, and contrast confined to a hiatal hernia were recorded qualitatively but not considered positive. Quantitative measurements, clearance patterns, morphology, interobserver reliability, and exploratory concordance with Chicago Classification v4.0-adjudicated categories were assessed. Results: TBE was positive in 12\/42 patients (28.6%). Mean age was 58.0 \u00b1 13.9 years; 26\/42 patients were female. In positive studies, mean column height and width were 122.9 \u00b1 65.4 mm and 31.1 \u00b1 17.8 mm at 1 min, and 89.0 \u00b1 54.6 mm and 28.2 \u00b1 18.2 mm at 2 min. Persistent 5 min retention occurred in two patients. Interobserver reliability was excellent (ICC 0.90). Morphologic abnormalities were frequent in positive examinations, supporting overall radiologic phenotype-based interpretation. In the EGJOO-focused subset, exploratory concordance metrics were 41.7%, 100%, 100%, and 46.2% for sensitivity-like, specificity-like, positive predictive, and negative predictive concordance, respectively. Conclusions: In this small exploratory cohort, standardized TBE provided functional and morphologic information on esophageal bolus transit. Positive TBE findings showed exploratory concordance with clinically relevant EGJOO, whereas a negative study did not exclude it. These findings require validation in larger prospective cohorts.<\/jats:p>","DOI":"10.3390\/diagnostics16172743","type":"journal-article","created":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T08:02:27Z","timestamp":1787817747000},"page":"2743","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Timed Barium Esophagography in Esophagogastric Junction Outflow Obstruction: A Retrospective Radiologic Assessment"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0767-3884","authenticated-orcid":false,"given":"Vittorio","family":"Patan\u00e8","sequence":"first","affiliation":[{"name":"Precision Medicine Department, University of Campania \u201cLuigi Vanvitelli\u201d, Piazza Luigi Miraglia 2, 80138 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Piera","family":"Senneca","sequence":"additional","affiliation":[{"name":"Gastroenterology Unit, Hospital \u201cSan Giuseppe Moscati\u201d, 81031 Aversa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Teresa","family":"Giuffr\u00e8","sequence":"additional","affiliation":[{"name":"Precision Medicine Department, University of Campania \u201cLuigi Vanvitelli\u201d, Piazza Luigi Miraglia 2, 80138 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5841-4503","authenticated-orcid":false,"given":"Marta","family":"Pagliaro","sequence":"additional","affiliation":[{"name":"Gastroenetology Unit, Pineta Grande Hospital, 81030 Castel Volturno, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonio","family":"Cefaliello","sequence":"additional","affiliation":[{"name":"Gastroenterology Unit, Hospital \u201cSan Giuseppe Moscati\u201d, 81031 Aversa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matteo","family":"Flaminio","sequence":"additional","affiliation":[{"name":"Department of Clinical Medicine and Surgery, University of Naples Federico II, 80131 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mario","family":"Ricchiuti","sequence":"additional","affiliation":[{"name":"Department of Clinical Medicine and Surgery, University of Naples Federico II, 80131 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Russo","sequence":"additional","affiliation":[{"name":"Precision Medicine Department, University of Campania \u201cLuigi Vanvitelli\u201d, Piazza Luigi Miraglia 2, 80138 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Chiara","family":"Brunese","sequence":"additional","affiliation":[{"name":"Precision Medicine Department, University of Campania \u201cLuigi Vanvitelli\u201d, Piazza Luigi Miraglia 2, 80138 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giovanni","family":"Sarnelli","sequence":"additional","affiliation":[{"name":"Department of Clinical Medicine and Surgery, University of Naples Federico II, 80131 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0566-3199","authenticated-orcid":false,"given":"Roberto","family":"Grassi","sequence":"additional","affiliation":[{"name":"Precision Medicine Department, University of Campania \u201cLuigi Vanvitelli\u201d, Piazza Luigi Miraglia 2, 80138 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5996-4259","authenticated-orcid":false,"given":"Marcella","family":"Pesce","sequence":"additional","affiliation":[{"name":"Department of Clinical Medicine and Surgery, University of Naples Federico II, 80131 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4809-6235","authenticated-orcid":false,"given":"Alfonso","family":"Reginelli","sequence":"additional","affiliation":[{"name":"Precision Medicine Department, University of Campania \u201cLuigi Vanvitelli\u201d, Piazza Luigi Miraglia 2, 80138 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,8,27]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"2684","DOI":"10.1007\/s11605-023-05844-0","article-title":"Peroral Endoscopic Myotomy (POEM) and Laparoscopic Heller Myotomy with Dor Fundoplication for Esophagogastric Junction Outflow Obstruction (EGJOO): A Comparison of Outcomes and Impact on Physiology","volume":"27","author":"Sarici","year":"2023","journal-title":"J. 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