Esophagus x-ray is a method of radiation diagnostics, which is aimed at visualizing the esophagus when a barium suspension passes through it. It helps to determine the location of this organ, the structure of the walls and sphincters, the size of the lumen, as well as to conclude about the features of its motor skills. It allows you to identify inflammation, diverticula, neoplasms, hernia of the esophageal orifice of the diaphragm, rupture of the esophagus, developmental abnormalities, ulcers, bleeding and perforation of the wall. Esophagography with barium is usually performed as an independent procedure, sometimes combined with an X-ray of the stomach.
Esophagus x-ray with contrast is shown to patients with signs of dysfunction of this organ. The procedure is prescribed to persons who have dysphagia for the first time, including symptoms such as a violation of the act of swallowing, pain behind the sternum after eating, a feeling of “lump in the throat”, vomiting of freshly taken or partially digested food, heartburn, weight loss. Esophagus x-ray with barium is carried out if:
- peptic ulcer of the esophagus;
- perforation of an ulcer or bleeding from the upper gastrointestinal tract;
- diverticula of the esophagus;
- esophageal stenosis;
- neoplasms of the esophagus;
- gastroesophageal reflux disease.
The procedure is performed in case of chest injuries with signs of rupture of the esophagus or hernia of the esophageal orifice of the diaphragm. For preventive purposes, radiography with barium is used after surgical interventions and in patients with congenital malformations of the esophagus or diaphragm.
Esophagus x-ray is contraindicated for women at any stage of pregnancy, patients in unstable or critical condition, younger children. The use of contrast enhancement (barium sulfate) is prohibited in persons with allergies to barium, patients with intestinal obstruction and cystic fibrosis, esophageal-tracheal fistulas.
Preliminary instrumental studies, as a rule, are not carried out, an exception may be a survey radiography of the OGC. In most cases, esophagus x-ray does not require specific preparation. Sometimes the patient is recommended to abstain from eating 4-6 hours before the procedure. Before starting the study, the patient needs to undress to the waist. To better visualize the structure of the esophagus and assess its motor function during the study, it is necessary to drink 200 ml of barium sulfate – a thick white liquid with a metallic taste.
Methodology of conducting
Before starting the study, an overview chest X-ray is performed. Then the patient is given a small sip of barium contrast to drink. The radiologist on the monitor of the X-ray unit traces the act of swallowing and the rate of movement of barium into the stomach. After the patient drinks all the barium suspension, take pictures in straight, lateral, oblique projections. Esophagus x-ray is performed in a standing position, sometimes lying down.
The duration of the procedure is several minutes. This diagnostic technique does not cause unpleasant sensations in the patient. You can get a ready-made picture “on your hands” in 20-40 minutes. If an additional description of the image is required by a radiologist, this time can be increased up to 1 hour (with a large workload of a specialist – up to a day).
Interpretation of results
When describing images of the esophagus, the radiologist indicates the characteristics of the act of swallowing, the condition of the walls of the esophagus; the presence of stenoses and protrusions, fistulas and ulcers, tumor deformities; the relief of the mucosa in the pathologically altered zone. According to the results of esophagus x-ray with barium, the following pathological changes characteristic of certain diseases can be detected:
- Violation of the normal structure of the esophageal wall on the X-ray indicates the presence of esophagitis, peptic ulcer, diverticulum and esophageal neoplasms.
- When the esophagus ruptures, the image shows a “breakage” of the organ and the release of barium sulfate into the abdominal cavity or mediastinum.
- When the organ is perforated, a through-wall defect is detected, which is also accompanied by the contrast going beyond the lumen.
- Stenosis and developmental abnormalities are characterized by narrowing of the esophageal cavity or its complete overlap with proximal expansion of the walls.
- Hernia of the esophageal orifice of the diaphragm on esophagus x-ray with barium is manifested by the expansion of the cardiac department, the exit into the thoracic cavity of part or the entire stomach.
- Structural abnormalities of the cardiac sphincter may indicate GERD.