Barium Swallow - جامعة الملك سعود

Barium Swallow . Introduction

A barium swallow is a test used to determine the cause of painful swallowing, difficulty with swallowing, abdominal pain, or unexplained weight loss.

These problems can be detected with a barium swallow:

Narrowing of the esophagus (the muscular tube between the back of the throat and the stomach) Disorders of swallowing

Abnormally enlarged veins in the esophagus that cause bleeding Ulcers Tumors Polyps (growths that are usually not cancerous, but could be precancerous)

To Prepare: Do not eat or drink anything, including water, after midnight before the test.

If you are pregnant, or think you might be, tell the staff before the x-ray is taken. a (

s -t m e d i a

( s- t m e

d i a Descends slowly and tend to coat the mucosal lining

Anatomy: When the esophagus is empty , the mucosa coat is thrown into three or four straight longitudinal folds

appeared as straight parallel lines throughout the esophagus Oesophagus Oesophagus

Normal indentations There are Two normal indentations of the esophagus 1- At the aortic arch 2- At the left bronchus Basic Positions

RAO (35 to 40) Lateral

AP LAO AP - LAT AP

LAT - RAO LAT LAT - RAO

LAT Lateral

Because the esophagus is thrown away from the spine, allowing better visualization LAT - RAO

RAO LAT - RAO RAO

RAO The esophagus is seen between the heart and the spine

The patient is rotate 35- 40 degrees with the RT side against the table Abnormalities

1.Oesophageal Varices They appear inside the oesophagus and occasionally they occur in the stomach. Varices develop when most of the normal liver tissue has been

replaced by scar tissue. Because the scar tissue pushes upon the veins in the liver, blood cannot flow normally through the veins. 1.Oesophageal Varices

1.Oesophageal Varices What is the radiographic appearance ? There are multiple submucosal filling

defects in a barium filled esophagus in AP view. 2. Achalasia Achalasia is a disease of esophagus .

The term achalasia means "failure to relax" and refers to the inability of the lower esophageal sphincter (a ring of muscle situated between the lower esophagus and the stomach) to open and let food pass into the stomach. As a result, patients with achalasia have

difficulty in swallowing food. 2. Achalasia 2. Achalasia Lower Esophagus

Proximal Dilatations Distal Narrowing

What is the radiographic appearance ? Dilated smooth outlined barium filled esophagus with narrow tapering lower end of the esophagus with smooth outline and absence of fundal gas in stomach. .

( Rat Tail or Bird Beak Deformity) 3. Zenker's diverticulum (ZD)

Is a blind sac (pouch) that branches off the cervical esophagus. It is the most common type of esophageal diverticulum. 3. Zenker's diverticulum (ZD)

3. Zenker's diverticulum (ZD) 3. Zenker's diverticulum (ZD)

diverticula appeared as smoothly marginated round-to-ovoid sacs. The size of the openings of the diverticula depended on the location of the barium bolus .

4.Foreign body Anteroposteri or chest radiograph depicts a

penny at the thoracic inlet of a 13month-old infant who refused to 4.Foreign body

Lateral chest radiograph depicts soft-tissue thickening at the tracheoesophagea

l interface. A penny was removed at esophagoscopy.

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