Cardiospasm with diffuse dilatation of the esophagus is often seen with angulation in the lower third of the organ, but it is rarely seen with angulation in the upper portion. In a recent report by Schall it has been shown that marked angulation of a normal esophagus may be associated with kyphosis. In the case reported here the esophagus is dilated as the result of spasmodic obstruction at the cardia, and the angulation in the upper portion is probably from spinal curvature. Another point of interest is the temporary retention of barium in the upper esophageal pouch noted in the roentgenogram, anteroposterior view. Examination of such a film without fluoroscopic observation might readily result in an erroneous diagnosis of malignant stricture of the upper esophagus. Report of Case A man, aged sixty-five, was examined at the Mayo Clinic November 29, 1924. For six years he had experienced a sense of obstruction in the median-esophageal region to the passage of any type of food, and he frequently regurgitated food and mucus after meals and at night. Food was regurgitated that had been eaten two or three days previously. In the course of five years he had gradually lost 75 pounds, but during the last year he had regained 10 pounds. He coughed occasionally, following which he regurgitated food. Pain had not been experienced. General physical examination was negative, save for considerable kyphosis. Roentgen-ray examination revealed wide dilatation of the esophagus, and obstruction of the barium meal at the cardia. The cardia was stretched with the hydrostatic dilator and complete relief from dysphagia resulted. The patient returned for examination October 27, 1926. The dysphagia had recurred recently, although it was not so marked as at the previous visit. Roentgenograms at this time showed obstruction of the barium meal at the cardia, with diffuse dilatation of the esophagus, and angulation in the upper third of the organ, with considerable sacculation above the angle (Figs. 1 and 2). Esophagoscopic examination was made without difficulty and, although the entire esophagus was widely dilated and filled with food particles and mucus, a definite angulation was not observed. Following another divulsion of the cardia with the hydrostatic dilator, the patient was able to eat any type of food without the slightest difficulty.