Radionuclide accumulation in the proximal esophagus during esophageal scintigraphy

A 7-year-old boy with acid regurgitation, heartburn, vomiting, and frequent respiratory infections in the previous 3 months underwent gastroesophageal scintigraphy to evaluate reflux. He had a history of congenital atresia of the esophagus with a fistula located between the trachea and the upper esophageal pouch and other associated congenital abnormalities, including those of the genitourinary tract and heart. Since his birth, surgery had been done to close the fistula, canalize the esophagus, perform esophageal anastomosis, and to obviate gastroesophageal reflux with a Nissen fundoplication. Esophageal scintigraphy showed significant holdup (>50% of ingested activity) of Tc-99m hepatate-labeled orange juice in the proximal third of the esophagus, which was confirmed by a barium stud