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Background Esophagogastric junction ( EGJ) outflow obstruction ( EGJOO) is characterized by impaired EGJ relaxation with intact or weak peristalsis. Our aims were to evaluate: (i) prevalence, (ii) yield of fluoroscopy, endoscopy, and endoscopic ultrasound ( EUS), (iii) outcomes, and (iv) whether this data differed based on quantitative EGJ relaxation. Methods Studies that met criteria for EGJOO were identified. Demographics, encounters, endoscopy, radiology, treatment decisions, and outcomes were extracted. Key Results Sixty studies were identified. Dysphagia was the most common symptom. Forty patients underwent barium esophagram ( BE): normal (11), hiatal hernia (20), spasm/dysmotility (17), EGJ narrowing (10), compression (2), Schatzki's ring (5), malrotation (1), gastric volvulus (1), mass (1). Esophagogastroduodenoscopy ( EGD) was performed in 41 patients: normal (19), hiatal hernia (13), Schatzki's ring (6), esophagitis (3), esophageal candidiasis (3), mass (1). EUS was performed in 20 patients and was frequently normal. Twenty-two 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-oral endoscopic myotomy. No patients treated with medical therapy alone had improvement in dysphagia. There was no difference in symptoms or outcomes based on quantitative EGJ relaxation. Conclusions & Inferences The manometric criterion EGJOO defines a heterogeneous clinical group. While BE, EGD, and EUS all provide complementary information, a significant percentage of these studies will be normal. For patients with dysphagia, outcome may depend on EGJ disruption. There were no differences in symptoms our outcomes based on quantitative EGJ relaxation. [ABSTRACT FROM AUTHOR]

The article presents a case study of a 67-year-old woman who was presented to the emergency department with complaints of nausea, vomiting, abdominal pain, and distention three days post-intragastric balloon insertion. Topics discussed include risk factors associated with intragastric balloons, the difficulty in deciphering expected post-intragastric balloon insertion symptoms, and the use of intragastricballoons for weight loss.

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