Behind the appendix, the oesophagus is the second most narrow section of the gastrointestinal tract. To further complicate the interpretation of barium swallow images or the passage of endoscopes and tubes, the oesophagus also has a number of constrictions - regions of narrowing evident on distention:
Rarely, an enlarged left atrium may cause a constriction; conversely, gastrointestinal endoscopy combined with ultrasonography has been used to image the heart.
The sites of constriction are also commonly the points at which large or irregular foreign bodies impact during descent through the lumen.
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