Fixed transverse folds in the esophagus: a sign of reflux esophagitis

Abstract

Scarring from reflux esophagitis is usually manifested by circumferential stricture formation. This article reports 17 cases in which double-contrast esophagography demonstrated fixed transverse folds in the esophagus, presumably secondary to longitudinal scarring from reflux esophagitis. In all cases, pooling of contrast material between the folds produced a series of horizontal, relatively parallel collections of barium in a "stepladder" arrangement. This appearance should be distinguished from linear ulcerations, tertiary esophageal contractions, and the delicate transverse striations that are occasionally observed as a transient phenomenon on the double-contrast examination.