Imaging

Esophagitis

Preliminary Diagnosis: Esophagitis

I. What imaging technique is first-line for this diagnosis?

Double contrasted fluoroscopic evaluation of the esophagus using effervescent granules, thin and thick liquid barium, and a barium pill

II. Describe the advantages and disadvantages of this technique for diagnosis of esophagitis.

Advantages

  • Relatively quick, highly portable imaging modality

  • Offers exquisite visualization of the esophageal mucosa

Disadvantages

  • May expose patients to large amounts of ionizing radiation

  • Less sensitive and specific in evaluating the surrounding soft tissues and osseous structures

III. What are the contraindications for the first-line imaging technique?

  • May be contraindicated in pregnant patients

IV. What alternative imaging techniques are available?

  • CT of the chest and abdomen with PO contrast

V. Describe the advantages and disadvantages of the alternative techniques for diagnosis of esophagitis.

CT of the chest and abdomen with PO contrast

Advantages

  • Offers better evaluation of regional and distal extension of inflammatory or neoplastic disease than other imaging modalities

  • Offers better evaluation of the surrounding soft tissues and osseous structures than other imaging modalities

Disadvantages

  • Offers less exquisite evaluation of the esophageal mucosa

  • May expose patients to large amounts of ionizing radiation

VI. What are the contraindications for the alternative imaging techniques?

CT of the chest and abdomen with PO contrast

  • May be contraindicated in pregnant patients

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