Transmigration of the lower esophageal mucosa.

From the earliest days of roentgenology the esophagogastric segment has intrigued the observer, and the anatomical landmarks have been variously interpreted by a multitude of workers. As pointed out by Cimmino (1), over a thousand papers dealing with this very small area appeared between 1930 and 1946. A variety of terms has been used to describe an appearance seen both at fluoroscopy with barium swallow and on roentgenograms, suggesting prolapse of the lower esophagus into a gastric hiatal hernia or into the gastric fundus below the diaphragm. A paper published in France in 1934 made the first mention of “invagination of the esophagus” (5). Since its appearance there have been sporadic references to the subject, almost all in the European literature. In 1951, Feldman described retrograde extrusion or prolapse of the gastric mucosa into the esophagus in 2 cases, and referred to the only other known example, reported by Wells in 1947 (11). Feldman considered the condition completely separated from hiatal h...