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Figure 4.  Peptic stricture with fixed transverse folds. Double-contrast esophagogram shows a mild peptic stricture in the distal esophagus (white arrow) with barium collections between fixed transverse folds (black arrows), findings that produce a characteristic "stepladder" appearance. Note that the folds are wider than the delicate transverse striations in feline esophagus and do not extend more than halfway across the esophagus.