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
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 Varices develop when most of the normal liver tissue has been
replaced by scar tissue.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)
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