We report a case of diffuse esophageal spasm diagnosed after computed tomography and endosonography. A 46-year-old male was referred to our hospital because of nausea. Recurrent upper abdominal pain lasted for 10 years, and coronary angiography had disclosed a normal finding five years ago. After admission, computed tomography and endoscopic ultasonography revealed the wall thickening of the lower-half esophagus, and endoscope showed spastic contactions of the same part of esophageal wall. X-ray study showed the“rosary bead”appearance, and manometory at 3cm，8cm，and 13cm above the LES revealed the simultaneous contractions. The patient did not wish surgical procedure, and the combination of recurrent hydrostatic balloon-dilation of lower esophagus and medication of nifedipine, lorazepam, and famotidine leaded to symptom improvement.
