Barium Swallow

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Technique

 
  • From a radiological viewpoint, the esophagus can be divided into three anatomical parts

 

  • The upper esophagus consisting of the hypopharynx and the cervical esophagus. The hypopharynx extends form the epiglottis to the cricoid cartilage opposite the 6th cervical vertebra where it becomes the cervical esophagus, which continues into the thoracic inlet where it becomes the thoracic esophagus.

 

  • The thoracic esophagus begins at the thoracic inlet and ends at the esophageal hiatus of the diaphragm.

 

  • The abdominal esophagus consists of the lower 2-4 cm of the esophagus intraabdominally till the gastroesophageal junction.

  • The patient takes a large mouthful of barium and retains it in the mouth.

 

  • Cineradiography employed in the frontal and lateral projections at frame speed of 50-100 per second, and videotape recording, are the best technique for investigating disorders of swallowing.

 

  • Photo-fluoroscopy at 4-6 frames per second is suitable when a structural abnormality is suspected.

  • Conventional spot film radiography with precise timing of the exposures can successfully demonstrate structural abnormality in patients who are able to swallow barium in order.

 

    Esophageal Achalasia

     
    1.Moderately dilated esophagus
    2.Smooth lower tapering to the cardioesophageal junction
    3.Cigar tip appearance

    Esophageal Achalasia

     
    1.Hugely dilated esophagus
    2.Smooth lower tapering to the cardioesophageal junction
    3.Parrot beak appearance

    Esophageal Achalasia

     
    1.Hugely dilated esophagus
    2.Smooth lower tapering to the cardioesophageal junction
    3.Sigmoid appearance of the esophagus

    Esophageal Carcinoma 1

     
    1.Mild dilated esophagus
    2.irregular filling defect, upper border is roughly horizontal and resembles a shelf or shoulder (shouldering sign).
    3.Apple-core appearance of the lesion

    Esophageal Carcinoma 2

     

    Lateral view of middle third esophageal carcinoma

    Esophageal Carcinoma 3

     

    Lateral view of lower third esophageal carcinoma

    Esophageal Atresia