Esophagogastric junction contractile integral

The esophagogastric junction contractile integral (EGJ-CI) measures vigor of the EGJ barrier using a software tool that encompasses length and vigor of the EGJ above the gastric baseline. The measurement is made over three respiratory cycles during rest and corrected for duration of respiration. Three examples are shown with progressive LES-crural diaphragm (CD) separation and diminishing EGJ-CI values. Note that the middle panel is indeterminant for hiatal hernia (HH) because the sphincter complex may, alternatively, be moving up and down 2 cm with respiration with no axial LES-CD separation. Note also that some investigators restrict the EGJ-CI box to the LES component when LES-CD separation is complete; the effect of that is illustrated in the 4 cm LES-CD separation on the right.