The Comprehensive Guide to Esophagus Barium Swallow Test: Understanding the Procedure and Its Benefits
What is an esophagus barium swallow test? How does it work? What are the common uses of this procedure? Get the answers to these and other questions in this detailed guide.
Understanding the Esophagus Barium Swallow Test
An esophagus barium swallow test, also known as an upper gastrointestinal (GI) tract radiography or barium swallow, is a diagnostic procedure that uses a special form of x-ray called fluoroscopy and a barium-based contrast material to produce images of the esophagus, stomach, and small intestine. This non-invasive test helps physicians diagnose and treat various medical conditions affecting the digestive system.
What is Upper Gastrointestinal (GI) Tract Radiography?
Upper gastrointestinal tract radiography, or upper GI, is an x-ray examination that focuses on the esophagus, stomach, and first part of the small intestine (duodenum). During this procedure, the patient ingests a barium-based contrast material, which allows the radiologist to view and assess the anatomy and function of these digestive organs.
Common Uses of the Esophagus Barium Swallow Test
The esophagus barium swallow test is commonly used to evaluate digestive function and detect various medical conditions, such as:
- Ulcers
- Tumors
- Inflammation of the esophagus, stomach, and duodenum
- Hiatal hernias
- Scarring
- Blockages
- Abnormalities of the muscular wall of the GI tract
- Anatomical problems like intestinal malrotation
Additionally, the test can help diagnose the cause of symptoms such as difficulty swallowing, chest and abdominal pain, reflux, unexplained vomiting, severe indigestion, and blood in the stool (indicating internal GI bleeding).
How to Prepare for the Esophagus Barium Swallow Test
Proper preparation is crucial for the success of the esophagus barium swallow test. Your physician will provide detailed instructions on how to prepare for the procedure, which may include:
- Informing your doctor about all medications you are taking and any allergies, especially to iodine or contrast materials
- Avoiding eating or drinking anything, including oral medications, after midnight on the day of the examination
- Removing jewelry, removable dental appliances, eyeglasses, and any metal objects or clothing that might interfere with the x-ray images
- Changing into a gown if requested
It is important to follow these instructions carefully to ensure the best possible image quality and accurate results.
What to Expect During the Esophagus Barium Swallow Test
The esophagus barium swallow test typically uses a radiographic table, one or two x-ray tubes, and a video monitor. The procedure involves the following steps:
- The patient will be asked to swallow a barium-based contrast material, which coats the esophagus, stomach, and small intestine, making them visible on the x-ray images.
- The radiologist will use fluoroscopy, a special form of x-ray that produces real-time video images, to watch and guide the procedure.
- The patient may be asked to change positions or perform specific actions, such as swallowing or taking a deep breath, to obtain better images of the digestive organs.
- The radiologist will carefully monitor the patient’s swallowing and digestive function throughout the procedure.
The entire process typically takes 30 minutes to an hour, depending on the specific requirements of the examination.
Understanding the Safety Considerations
The esophagus barium swallow test is considered a safe and non-invasive procedure. However, as with any x-ray examination, there is a small amount of radiation exposure. Pregnant women or those who may be pregnant should inform their doctor, as the test may be postponed or alternative imaging methods may be considered to minimize radiation exposure to the fetus.
Patients with certain medical conditions or allergies may also require special considerations, such as the use of alternative contrast materials. It is important to discuss any concerns or medical history with your healthcare provider before the procedure.
Interpreting the Results of the Esophagus Barium Swallow Test
The radiologist will carefully analyze the images obtained during the esophagus barium swallow test to identify any abnormalities or issues within the digestive system. The results of the test will be discussed with the patient’s primary healthcare provider, who will then use the information to develop an appropriate treatment plan.
It is important to note that the interpretation of the test results requires specialized medical expertise, and patients should not attempt to interpret the images or results on their own.
Upper GI | Esophagram | Barium Swallow
Upper gastrointestinal tract radiography or upper GI uses a form of real-time x-ray called fluoroscopy and a barium-based contrast material to produce images of the esophagus, stomach and small intestine. It is safe, noninvasive, and may be used to help accurately diagnose pain, acid reflux, blood in the stool and other symptoms.
You will be instructed on how to prepare. Your stomach must be empty, so you will likely be told not to eat or drink anything (including oral medications) or chew gum after midnight the night before. Tell your doctor if there’s a possibility you are pregnant and discuss any recent illnesses, medical conditions, medications you’re taking and allergies, especially to contrast materials. Leave jewelry at home and wear loose, comfortable clothing. You may be asked to wear a gown.
What is Upper Gastrointestinal (GI) Tract Radiography?
Upper gastrointestinal tract radiography, also called an upper GI, is an x-ray examination of the esophagus, stomach and first part of the small intestine (also known as the duodenum).
Images are produced using a special form of x-ray called fluoroscopy and an orally ingested contrast material such as barium.
An x-ray exam helps doctors diagnose and treat medical conditions. It exposes you to a small dose of ionizing radiation to produce pictures of the inside of the body. X-rays are the oldest and most often used form of medical imaging.
Fluoroscopy makes it possible to see internal organs in motion. When the upper GI tract is coated with barium, the radiologist is able to view and assess the anatomy and function of the esophagus, stomach and duodenum.
An x-ray examination that evaluates only the pharynx and esophagus is called a barium swallow.
In addition to drinking barium, some patients are also given baking-soda crystals (similar to Alka-Seltzer) to further improve the images. This procedure is called an air-contrast or double-contrast upper GI.
On occasion, some patients are given other forms of orally ingested contrast, usually containing iodine.
These alternative contrast materials may be used if the patient has recently undergone surgery on the GI tract, or has allergies to other contrast materials. The radiologist will determine which type of contrast material will be used.
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What are some common uses of the procedure?
An upper GI examination helps evaluate digestive function and can detect:
- ulcers
- tumors
- inflammation of the esophagus, stomach and duodenum
- hiatal hernias
- scarring
- blockages
- abnormalities of the muscular wall of GI tract
- anatomical problems such as intestinal malrotation (a twisting of a baby’s intestine)
The procedure is also used to help diagnose the cause of symptoms such as:
- difficulty swallowing
- chest and abdominal pain
- reflux (a backward flow of partially digested food and digestive juices)
- unexplained vomiting
- severe indigestion
- blood in the stool (indicating internal GI bleeding)
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How should I prepare?
Your physician will give you detailed instructions on how to prepare for your upper GI.
Tell your doctor about all the medications you take. List any allergies, especially to iodine contrast materials. Tell your doctor about recent illnesses or other medical conditions.
Women should always tell their doctor and technologist
if they are pregnant. Doctors will not perform many tests during pregnancy to avoid exposing the fetus to radiation. If an x-ray is necessary, the doctor will take precautions to minimize radiation exposure to the baby. See the Safety in X-ray, Interventional Radiology and Nuclear Medicine Procedures page for more information about pregnancy and x-rays.
To ensure the best possible image quality, your stomach must be empty of food. Therefore, your doctor will likely ask you not to eat or drink anything (including any medications taken by mouth, especially antacids) and to refrain from chewing gum after midnight on the day of the examination.
You may need to remove some clothing and/or change into a gown for the exam.
Remove jewelry, removable dental appliances, eyeglasses, and any metal objects or clothing that might interfere with the x-ray images.
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What does the x-ray equipment look like?
This exam typically uses a radiographic table, one or two x-ray tubes, and a video monitor. Fluoroscopy converts x-rays into video images. Doctors use it to watch and guide procedures. The x-ray machine and a detector suspended over the exam table produce the video.
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How does the procedure work?
X-rays are a form of radiation like light or radio waves. X-rays pass through most objects, including the body. The technologist carefully aims the x-ray beam at the area of interest. The machine produces a small burst of radiation that passes through your body. The radiation records an image on photographic film or a special detector.
Fluoroscopy uses a continuous or pulsed x-ray beam to create images and project them onto a video monitor.
Your exam may use a contrast material to clearly define the area of interest. Fluoroscopy allows your doctor to view joints or internal organs in motion. The exam also captures still images or movies and stores them electronically on a computer.
Most x-ray images are electronically stored digital files. Your doctor can easily access these stored images to diagnose and manage your condition.
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How is the procedure performed?
A radiologic technologist and a radiologist, a physician specifically trained to supervise and interpret radiology examinations, guide the patient through the upper GI series.
As the patient drinks the liquid barium, which resembles a light-colored milkshake, the radiologist will watch the barium pass through the patient’s digestive tract on a fluoroscope, a device that projects radiographic images in a movie-like sequence onto a monitor. The exam table will be positioned at different angles and the patient’s abdomen may be compressed to help spread the barium.
Once the upper GI tract is adequately coated with the barium, still x-ray images will be taken and stored for further review.
Children usually drink barium contrast material without any objection. If a child will not drink the contrast, the radiologist may need to pass a small tube into the stomach to complete the examination.
Very young children may be placed on a special rotating platform to help turn them into slanted positions. This allows the radiologist to see all the organs. Older children will be asked to hold very still and may be asked to hold their breath for a few seconds while the x-ray pictures are taken.
Older children may undergo a double-contrast upper GI series. The patient will swallow baking-soda crystals that create gas in the stomach while additional x-rays are taken.
When the examination is complete, the technologist may ask you to wait until the radiologist confirms they have all the necessary images.
This exam is usually completed within 20 minutes.
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What will I experience during and after the procedure?
Occasionally, patients find the thick consistency of the barium unpleasant and difficult to swallow. The liquid barium has a chalky taste that may be masked somewhat by added flavors such as strawberry or chocolate.
Being tilted on the examination table and having pressure applied to the abdomen can be uncomfortable for some patients. The examination may also make you feel bloated.
If you receive gas-producing crystals, you may feel the need to belch. However, the radiologist or technologist will tell you to try to hold the gas in (by swallowing your saliva if necessary) to enhance the detail on the x-ray images.
In some medical centers, the technologist can minimize patient movement by automatically tilting the examining table. These actions ensure that the barium is coating all parts of the upper GI tract. As the procedure continues, the technologist or the radiologist may ask you to drink more barium.
You may hear the mechanical noises of the radiographic apparatus moving into place during the exam.
After the examination, you can resume a regular diet and take orally administered medications unless instructed otherwise by your doctor.
The barium may color your stools gray or white for 48 to 72 hours after the procedure. Sometimes the barium can cause temporary constipation, which is usually treated by an over-the-counter laxative. Drinking large quantities of fluids for several days following the test can also help. If you are unable to have a bowel movement or if your bowel habits undergo any significant changes following the exam, you should contact your physician.
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Who interprets the results and how do I get them?
A radiologist, a doctor trained to supervise and interpret radiology examinations, will analyze the images. The radiologist will send a signed report to your primary care or referring physician who will discuss the results with you.
You may need a follow-up exam. If so, your doctor will explain why. Sometimes a follow-up exam further evaluates a potential issue with more views or a special imaging technique. It may also see if there has been any change in an issue over time. Follow-up exams are often the best way to see if treatment is working or if a problem needs attention.
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What are the benefits vs. risks?
Benefits
- Upper GI tract radiography is an extremely safe, noninvasive procedure.
- The results of the upper GI series usually lead to accurate evaluation of the esophagus, stomach and duodenum.
- Because barium is not absorbed into the blood, allergic reactions are extremely rare.
- No radiation stays in your body after an x-ray exam.
- X-rays usually have no side effects in the typical diagnostic range for this exam.
Risks
- There is always a slight chance of cancer from excessive exposure to radiation.
However, given the small amount of radiation used in medical imaging, the benefit of an accurate diagnosis far outweighs the associated risk. - The radiation dose for this procedure varies. See the Radiation Dose in X-Ray and CT Exams page for more information about radiation dose.
- Occasional patients may be allergic to the flavoring added to some brands of barium. If you have experienced allergic reactions after eating chocolate, certain berries or citrus fruit, be sure to tell your physician or the technologist before the procedure.
- There is a slight chance that some barium could be retained, leading to a blockage of the digestive system. Therefore, patients who have a known obstruction in the GI tract should not undergo this examination.
- Women should always tell their doctor and x-ray technologist if they are pregnant. See the Safety in X-ray, Interventional Radiology and Nuclear Medicine Procedures page for more information about pregnancy and x-rays.
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However, given the small amount of radiation used in medical imaging, the benefit of an accurate diagnosis far outweighs the associated risk.
A Word About Minimizing Radiation Exposure
Doctors take special care during x-ray exams to use the lowest radiation dose possible while producing the best images for evaluation. National and international radiology protection organizations continually review and update the technique standards radiology professionals use.
Modern x-ray systems minimize stray (scatter) radiation by using controlled x-ray beams and dose control methods. This ensures that the areas of your body not being imaged receive minimal radiation exposure.
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What are the limitations of Upper Gastrointestinal (GI) Tract Radiography?
Mild irritation of the lining of the stomach or esophagus is difficult to detect, as well as ulcers smaller than 1/4 inch in diameter. The test will detect larger ulcers. It can also suggest the presence of underlying infection with the bacterium, Helicobacter pylori, the most common cause of ulcers; but additional noninvasive tests such as a blood test or breath test may be required to confirm this infection.
Finally, biopsies of any abnormal areas cannot be performed with this test.
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This page was reviewed on May, 05, 2019
What to Expect from Your Barium Swallow Test
n exam called a barium swallow test is often used to diagnose disorders that make swallowing difficult or affect the upper gastrointestinal (GI) tract (esophagus, stomach and the first part of the small intestine). The barium swallow is a special kind of X-ray test that allows the doctor to view your pharynx (the back of your mouth and throat) and your esophagus (the tube that extends from the back of the tongue to the stomach).
Basics and Conditions Diagnosed
This test involves swallowing a chalky white substance called barium, which is often mixed with water to make a thick, milkshake-like drink. When you swallow it the liquid coats the inside of your upper GI tract. Barium absorbs X-rays and appears white on X-ray images. This helps highlight what a doctor is looking at, including the inner lining of your GI tract and the motion of your swallowing, when X-rays are taken.
Common issues that the barium swallow test can help diagnose include:
- •Hiatal hernia
- •Inflammation
- •Blockages
- •Muscle disorders that could lead to spasms or trouble swallowing
- •Gastroesophageal reflux disease (GERD)
- •Ulcers
- •Cancerous or noncancerous tumors
- •Polyps (growths that usually aren’t cancerous but can grow into cancer)
- •Dysphagia (disorders of swallowing)
- •Narrowing of the esophagus
- •Abnormally enlarged veins in the esophagus that lead to bleeding
In some cases, the barium swallow is done as part of a group of X-rays that examine the entire upper GI tract. A test called fluoroscopy, which uses a continuous X-ray beam, is commonly used during a barium swallow. Another test that often comes with a barium swallow is an upper GI endoscopy.
Preparation
Your doctor may give you some dietary guidelines before your barium swallow test, and it’s important that you follow them closely if this is the case.
In most cases, you aren’t supposed to eat or drink anything for six hours prior to the test, though you can take small sips of water up until two hours beforehand. If the test is combined with others, or if you have any medical conditions, your doctor may give you slightly different directions. Notify your doctor in advance if you have or have had any of these conditions:
- A perforation of the esophagus or bowel
- Bowel obstruction
- Trouble swallowing
- Severe constipation
During the Test
The steps for a standard barium swallow test will go as follows:
- •You’ll go to a local radiology facility for your test, which will be performed by a radiology technician
- •You’ll be asked to remove your clothing and any jewelry, and will change into a medical gown
- •You’ll be positioned on an X-ray table, and potentially asked to move your body around as standard X-rays are taken of your heart, lungs and abdomen
- •After this first round of X-rays, you’ll be given a barium drink to swallow
- •Either X-rays or fluoroscopy will be done to watch how the barium moves through your pharynx and you may be asked to hold your breath at times to avoid disrupting the images
- •From here, you’ll be given a thinner barium drink to swallow, and another set of X-rays or fluoroscopy will be done to watch how it moves down the esophagus
When all X-rays are complete, you’ll be finished.
The test will take about 30 minutes, and there will be no restrictions to your diet or daily activities after the test unless your doctor specifies otherwise. You’ll hear from your doctor’s office within a few days to go over your test and schedule any necessary follow-up appointments.
Possible Side Effects
A barium swallow test does have some potential side effects, including constipation or fecal impaction. Drink lots of fluids and eat high-fiber foods to move the barium through your digestive tract, as these complications most often arise due to barium that remains in your body.
You may notice bowel movements that are lighter in color – once all the barium is removed from your body, this should stop. If you have trouble with bowel movements, pain or bloating in the abdomen, or stools that are smaller in diameter than usual, contact your doctor right away.
In addition, barium swallows do involve exposure to radiation from the X-ray. The risk of complications here can rise as your exposure over time does, and if you’re worried about this, you should review with your doctor all your past radiation procedures.
Pregnant women should avoid barium swallow procedures, as these can cause birth defects.
Your doctor can offer additional information on a barium swallow test and can recommend it for you if it’s necessary.
Sources:
“What to Expect from a Barium Swallow.” Healthline.com. https://www.healthline.com/health/barium-swallow#overview1
“Barium Swallow.” EMedicineHealth.com. https://www.emedicinehealth.com/barium_swallow/article_em.htm
Barium Swallow | Oral, Laryngeal and Thyroid Cancer
Who is a candidate for a barium swallow
A barium swallow may be able to help diagnose conditions such as:
- Hiatal hernia — where your stomach has moved up into or beside the esophagus
- Inflammation or blockages in the upper gastrointestinal tract
- Benign or malignant tumors (non-cancerous and cancerous) in the head, neck, pharynx and esophagus
- Gastric ulcers
- Gastroesophageal reflux disease (GERD)
- Structural conditions — conditions such as strictures (narrowing), polyps (growths), diverticula (pouches)
- Esophageal varices — enlarged veins
- Achalasia —medical condition where the lower esophageal sphincter won’t relax to allow food into the stomach
You may not be able to have a barium swallow if you have any of the following conditions:
- Tear or hole in the esophagus or intestines
- Severe constipation
- Problems swallowing that could accidentally allow barium to go into the lungs
- You are pregnant
What are the side effects associated with a barium swallow
Some people experience constipation or fecal impaction if the barium is not completely expelled from the body after the procedure.
If you experience constipation or fecal impaction, drink plenty of fluids and eat high-fiber foods to move the barium through the digestive tract. If that doesn’t work, your doctor can prescribe a laxative.
There are also side effects associated with the radiation that is used in the test. The risks associated with radiation exposure increase as you have more x-ray exams.
If you are pregnant or suspect you are pregnant, tell your doctor. Exposure to radiation during pregnancy can cause birth defects in unborn fetuses.
What to expect during a barium swallow
A barium swallow is performed in radiology by a radiology tech. The entire procedure takes approximately 30 minutes, and you should have results within a few days.
In preparation for the procedure, your technician will position you on the x-ray table, give you a barium drink and take a series of x-rays as the barium travels through the pharynx. Once the first set of x-rays has been taken, your technician will give you another, thinner barium drink and will take x-rays as the barium moves through the esophagus.
Barium is a chalky white substance that is used in the GI tract to help it show up on x-ray. Using barium, your doctor will be able to evaluate the size and shape of the pharynx and esophagus.
A barium swallow can be done as a standalone procedure or as a part of an upper GI series of tests that evaluate the entire upper GI tract. During this procedure, a fluoroscopy (a continuous x-ray beam) is used during a barium swallow to evaluate movement through your GI tract. In many cases, a barium swallow accompanies an esophagogastroduodenoscopy (EGD) or as a part of an upper GI and small bowel testing.
Recovery from a barium swallow
You will go home after a barium swallow and can return to your normal activities right away. You may experience constipation or notice that your bowel movements are lighter. Once the barium has passed from the body, your bowel function should return to normal.
If you experience any of the following side effects, call your doctor right away:
- Inability to have a bowel movement
- Pain in the abdomen
- Smaller than usual stools
Barium Swallow Video | Upper Gastrointestinal Tract Testing Video
Barium enema is a diagnostic procedure that uses X-rays to assess for abnormalities of the large intestine including the colon and rectum.
The contrast material containing barium outlines the lining of the colon and rectum to show a clear view on the X-ray image.
There are two types of barium enemas:
Single contrast study, in which the colon is filled with barium that outlines the intestine, and double contrast study in which the colon is filled with barium and is drained out leaving a thin layer of barium on the wall of the colon. The colon is then filled with air which provides a detailed view of its inner surface.
Indications.
Barium enema is used to identify inflammation of the intestinal wall and monitor the progress of ulcerative colitis or Crohn’s disease. It is also used to evaluate a variety of conditions which include:
Appendicitis.
Persistent abdominal pain.
Colon cancer and polyps.
Persistent diarrhea.
Diverticulitis.
Celiac sprue (Small intestinal lining damage).
Lower gastrointestinal bleeding.
Anemia or unexplained weight loss.
Pre-procedural preparation.
Before performing a barium enema, your doctor will review your medical history. Inform your doctor if you are pregnant, allergic to latex or barium, or have recently undergone any colon related tests. A thorough cleansing of the large intestine is necessary before the procedure. You will be instructed to follow a clear liquid diet for 1 to 3 days before the test and just prior to it a cleansing enema is usually administered to enable a clear view.
Procedure.
The steps involved in performing the procedure of a barium enema include:
A preliminary X-ray of the lower intestine will be taken while you lie on the X-ray table.
Following this, a well-lubricated enema tube will be gently inserted into your rectum and the barium contrast material will be allowed to flow into the colon.
The inflated balloon on the tip of the enema tube will help the barium to stay in the colon until the test is completed. Your doctor may give you an injection to relieve cramping.
You will be instructed on turning to different positions so that X-ray images can be taken from all sides of the body.
During a double-contrast procedure, your doctor will drain the barium and fill the colon with air.
After the test your doctor will remove the tube, allow you to pass the barium and take some additional X-ray images.
Post-Procedural Care.
Following the procedure, you may use the bathroom or a bedpan to expel the remaining barium. You will be advised to drink plenty of liquids to flush out the barium from your system. You may have white stools for 1 to 2 days and some constipation which is easily treated by laxatives and increased fluid intake. Consult your doctor if these problems persist.
Risks and complications.
Barium enema is a safe procedure with minimal risks. Potential risks and complications include:
Severe constipation or obstruction.
Inflamed areas in the colon called barium granulomas.
Colon perforation due to pressure of the barium or air.
A barium enema produces clear images of the colon and helps diagnose many diseases and abnormalities. The procedure is generally safe. Be sure to follow your pre and postoperative instructions carefully.
Barium Swallow or Esophagram Quick Reference Guide for Patients
The esophagram or barium swallow is a test where a patient is instructed to drink a barium sulfate compound that enables the radiologist to study the function and appearance of the esophagus and assess the swallowing process.
Indications
The esophagram can assess symptoms of painful or difficult swallowing, bloodstained vomit, abdominal pain and weight loss. The radiologist is able to detect narrowing or irritation of the esophagus, blockages, hiatal hernia, or abnormally enlarged veins that may cause bleeding in the esophagus, ulcers, polyps, or tumor.
Contraindications
Pregnancy. known or suspected esophageal perforation.
Patient Preparation
Eat/drink nothing by mouth on the day of the exam
CPT code
74220
General Information
What is a barium swallow (or esophogram)?
A barium swallow is an x-ray examination of the pharynx and esophagus using fluoroscopy and an orally ingested contrast material called barium.
Fluoroscopy makes it possible to see internal organs in motion. When coated with barium, the radiologist is able to view and assess the anatomy and function of the pharynx and esophagus. In addition to drinking barium, some patients are also given baking-soda crystals (similar to Alka-Seltzer) to further improve the images. This procedure is called an air-contrast or double-contrast upper GI.
An upper GI examination helps evaluate digestive function and can detect:
- ulcers
- tumors
- inflammation of the esophagus
- hiatal hernias
- scarring
- blockages
- abnormalities of the muscular wall of GI tissues
The procedure is also used to help diagnose the cause of symptoms such as:
- difficulty swallowing
- chest and abdominal pain
- reflux (a backward flow of partially digested food and digestive juices)
- unexplained vomiting
- severe indigestion
- blood in the stool (indicating internal GI bleeding)
Women should always inform their physician and x-ray technologist if there is any possibility that they are pregnant. Your patient may be asked to remove some or all of your clothes and to wear a gown during the exam. Your patient may also be asked to remove jewelry, dentures, eye glasses and any metal objects or clothing that might interfere with the x-ray images.
How is the procedure performed?
As you drink the liquid barium, which resembles a light-colored milkshake, the radiologist will watch the barium pass through your digestive tract on a fluoroscope, a device that projects radiographic images in a movie-like sequence onto a monitor. The exam table will be positioned at different angles and your abdomen may be compressed to help spread the barium. Once the GI tract is adequately coated with the barium, still x-ray images will be taken and stored for further review.
Children usually drink barium contrast material without any objection. If a child will not drink the contrast, the radiologist may need to pass a small tube into the stomach to complete the examination.
You will be asked to hold very still and may be asked to keep from breathing for a few seconds while the x-ray picture is taken to reduce the possibility of a blurred image.
For a double-contrast upper GI series, you will swallow baking-soda crystals that create gas in the stomach while additional x-rays are taken.
When the examination is complete, you will be asked to wait until the radiologist determines that all the necessary images have been obtained.
This exam is usually completed within 20 minutes.
What will I experience after the procedure?
After the examination, you can resume a regular diet and take orally administered medications.
The barium may color your stools gray or white for 48 to 72 hours after the procedure. Sometimes the barium can cause temporary constipation, which is usually treated by an over-the-counter laxative. Drinking large quantities of fluids for several days following the test can also help. If you are unable to have a bowel movement or your bowel habits undergo any significant changes following the exam, you should contact your doctor.
Questions?
If you have any questions or concerns about your procedure, feel free to call us at 203-453-5123 or contact us online.
How Is Esophageal Cancer Diagnosed?
Esophagus cancers are usually found because of signs or symptoms a person is having. If esophagus cancer is suspected, exams, tests, and a biopsy (a sample of esophagus cells) will be needed to confirm the diagnosis. If cancer is found, further tests will be done to help determine the extent (stage) of the cancer.
Medical history and physical exam
If you have symptoms that might be caused by esophageal cancer, the doctor will ask about your medical history to learn about your symptoms and possible risk factors.
Your doctor will also examine you closely to look for possible signs of esophageal cancer and other health problems.
If the results of your history and physical exam suggest you might have esophageal cancer, more tests will be done. These could include imaging tests and/or biopsies of the esophagus. You may also be referred to a gastroenterologist (a doctor specializing in digestive system diseases) for further tests and treatment.
Imaging tests for esophagus cancer
Imaging tests use x-rays, magnetic fields, sound waves, or radioactive substances to create pictures of the inside of your body. Imaging tests might be done for a number of reasons both before and after a diagnosis of esophageal cancer, including:
- To look at a suspicious area that might be cancer
- To learn how far cancer might have spread
- To help determine if the treatment is working
- To look for possible signs of cancer coming back after treatment
Barium swallow test
If you’re having trouble swallowing, sometimes a barium swallow is the first test done. In this test, you will be asked to swallow a thick, chalky liquid called barium to coat the walls of the esophagus. When x-rays are taken, the barium outlines the esophagus. This test can be done by itself, or as a part of a series of x-rays called an upper gastrointestinal (GI) series, that includes the stomach and part of the intestine
A barium swallow test can show any abnormal areas in the normally smooth inner lining of the esophagus, but it can’t be used to determine how far a cancer may have spread outside of the esophagus.
This test can show even small, early cancers. Early cancers can look like small round bumps or flat, raised areas (called plaques), while advanced cancers look like large irregular areas and can cause narrowing of the inside of the esophagus.
This test can also be used to diagnose one of the more serious complications of esophageal cancer called a tracheo-esophageal fistula. This occurs when the tumor destroys the tissue between the esophagus and the trachea (windpipe) and creates a hole connecting them. Anything that is swallowed can then pass from the esophagus into the windpipe and lungs. This can lead to frequent coughing, gagging, or even pneumonia. This problem can be helped with surgery or an endoscopy procedure.
Computed tomography (CT) scan
A CT scan uses x-rays to make detailed cross-sectional images of your body. Instead of taking 1 or 2 pictures, like a regular x-ray, a CT scanner takes many pictures and a computer then combines them to show a slice of the part of your body being studied.
This test can help tell if esophageal cancer has spread to nearby organs and lymph nodes (bean-sized collections of immune cells to which cancers often spread first) or to distant parts of the body.
Before the test, you may be asked to drink 1 to 2 pints of a liquid called oral contrast. This helps outline the esophagus and intestines. If you are having any trouble swallowing, you need to tell your doctor before the scan.
CT-guided needle biopsy: If a suspected area of cancer is deep within your body, a CT scan might be used to guide a biopsy needle into this area to get a tissue sample to check for cancer.
Magnetic resonance imaging (MRI) scan
Like CT scans, MRI scans show detailed images of soft tissues in the body. But MRI scans use radio waves and strong magnets instead of x-rays. MRI can also be used to look for possible cancer spread to the brain and spinal cord.
Positron emission tomography (PET) scan
For a PET scan, a slightly radioactive form of sugar (known as FDG) is injected into the blood and collects mainly in cancer cells. These areas of radioactivity can be seen on a PET scan using a special camera.
PET/CT scan: Sometimes a PET scan is combined with a CT scan using a special machine that can do both at the same time. This lets the doctor compare areas of higher radioactivity on the PET scan with the more detailed picture of that area on the CT scan.
PET/CT scans can be useful:
- In diagnosing esophageal cancer.
- If your doctor thinks the cancer might have spread but doesn’t know where. They can show spread of cancer to the liver, bones, or some other organs. They are not as useful for looking at the brain or spinal cord.
Endoscopy
An endoscope is a flexible, narrow tube with a tiny video camera and light on the end that is used to look inside the body. Tests that use endoscopes can help diagnose esophageal cancer or determine the extent of its spread.
Upper endoscopy
This is an important test for diagnosing esophageal cancer. During an upper endoscopy, you are sedated (made sleepy) and then the doctor passes an endoscope( a thin, flexible tube with a light and a small video camera on the end) down your throat and into the esophagus and stomach. The endoscope’s camera is connected to a monitor, which lets the doctor see any abnormal areas in the wall of the esophagus clearly.
The doctor can use special instruments through the scope to remove (biopsy) tissue samples from any abnormal areas. These samples are sent to the lab to check if they contain cancer.
If the esophageal cancer is blocking the opening (called the lumen) of the esophagus, certain instruments can be used to help enlarge the opening to help food and liquid pass.
Upper endoscopy can give the doctor important information about the size and spread of the tumor, which can be used to help determine if the tumor can be removed with surgery.
Endoscopic ultrasound
This test is usually done at the same time as the upper endoscopy. For an endoscopic ultrasound, a probe that gives off sound waves is at the end of an endoscope. This allows the probe to get very close to tumors in the esophagus. This test is very useful in determining the size of an esophageal cancer and how far it has grown into nearby areas. It can also help show if nearby lymph nodes might be affected by the cancer. If enlarged lymph nodes are seen on the ultrasound, the doctor can pass a thin, hollow needle through the endoscope to get biopsy samples of them. This helps the doctor decide if the tumor can be removed with surgery.
Bronchoscopy
This exam may be done for cancer in the upper part of the esophagus to see if it has spread to the trachea (windpipe) or the bronchi (tubes leading from the windpipe into the lungs).
Thoracoscopy and laparoscopy
These exams let the doctor see lymph nodes and other organs near the esophagus inside the chest (by thoracoscopy) or the abdomen (by laparoscopy) through a hollow lighted tube and can be used to get biopsy samples.
These procedures are done in an operating room while you are under general anesthesia (in a deep sleep). A small incision (cut) is made in the side of the chest wall (for thoracoscopy) or the abdomen (for laparoscopy). Sometimes more than one cut is made. The doctor then inserts a scope (a thin, lighted tube with a small video camera on the end) through the incision to view the space around the esophagus. The surgeon can pass thin tools into the space to remove lymph nodes and biopsy samples to see if the cancer has spread. This information is often important in deciding whether a person is likely to benefit from surgery.
Lab tests of biopsy samples
Usually if a suspected esophageal cancer is found on endoscopy or an imaging test, it is biopsied. In a biopsy, the doctor removes a small piece of tissue with a cutting instrument passed through the scope.
HER2 testing: If esophageal cancer is found but is too advanced for surgery, your biopsy samples may be tested for the HER2 gene or protein. Some people with esophageal cancer make too much of the HER2 protein or gene which helps the cells grow. A drug called trastuzumab (Herceptin) that targets the HER2 protein may help treat these advanced cancers when used along with chemotherapy. Only cancers that have too much of the HER2 gene or protein are likely to benefit from this drug, which is why doctors may test tumor samples for it. (See Targeted Therapy for Esophageal Cancer.)
PD-L1 testing: An esophageal cancer that cannot be treated with surgery or has spread to distant sites may be tested to see if it makes a checkpoint protein called PD-L1. This protein is found in 35% to 45% of esophageal cancers.
Tumors that make this protein might be treated with the immunotherapy drug pembrolizumab.
MMR and MSI testing: Esophageal cancer cells might be tested to see if they show high levels of gene changes called microsatellite instability (MSI), or if they have changes in any of the mismatch repair (MMR) genes (MLh2, MSh3, MSH6, and PMS2).
Esophageal cancers that test positive for MMR or high MSI and cannot be treated with surgery, have come back after initial treatment, or have spread to other parts of the body might benefit from immunotherapy with the drug pembrolizumab.
See Testing Biopsy and Cytology Specimens for Cancer to learn more about the types of biopsies, how the tissue is used in the lab to diagnose cancer, and what the results may show.
Blood tests
Your doctor might order certain blood tests if they think you have esophageal cancer.
Complete blood count (CBC): This test measures the different types of cells in your blood. It can show if you have anemia (too few red blood cells). Some people with esophageal cancer have low red blood cell counts because the tumor has been bleeding.
Liver enzymes: You may also have a blood test to check your liver function, because esophageal cancer can spread to the liver.
Barium swallow | CTCA
A barium swallow is a noninvasive X-ray technique commonly used to examine the throat and esophagus for swallowing difficulties and physical abnormalities, helping to detect problems such as gastroesophageal reflux disease (GERD), ulcers or polyps. It’s also a valuable tool to look for cancer in the upper digestive tract (from the mouth to the first part of the small intestine).
Doctors may use it specifically to diagnose esophageal (food pipe) cancer and stomach cancer, as well as head and neck cancers, including:
In addition to cancer, results from a barium swallow may detect:
- Ulcers
- Polyps
- Hiatal hernia (when part of the stomach protrudes up through the diaphragm)
- Esophageal stricture (a tight band of tissue)
- Diverticula (little pouches in the intestinal wall)
How it’s performed
The procedure uses X-ray images to follow the progress of a liquid containing barium sulfate, a metallic element from the earth, through the upper digestive tract. This group of X-rays is called an upper GI series.
- You’ll be evaluated using fluoroscopic imaging both upright and laying down on a X-ray capable table.
- You’ll drink a flavored liquid barium drink, which coats the lining of the digestive tract. This chalky liquid is called a contrast medium, as it shows up opaque on X-ray images.
- A radiologist then begins to take a series of X-ray images with you in different positions. You may need to hold your breath occasionally.
To facilitate an upper GI series, you may be asked to drink a fizzy liquid to distend your stomach with gas to separate the walls of your stomach.
A barium swallow may be used to focus on the throat and esophagus or to examine all of the upper gastrointestinal tract.
If your symptoms include dysphagia, or problems swallowing, your doctor may order a video version of the test to determine the cause and look for signs of esophageal, laryngeal or hypopharyngeal cancers. An instrument called a fluoroscope helps track the movement of the barium, which is displayed on a video monitor. In this instance, the test is called an esophagram.
Other names for it are modified barium swallow and videofluoroscopy.
The test also may be used if your doctor suspects cancer has opened a fistula, or hole, between the esophagus and trachea (windpipe). This serious complication may result in swallowed food and liquid passing into the lungs, where it may cause pneumonia.
Though a barium swallow may be used to check for stomach cancer, physicians more often introduce an endoscope through the mouth or nose down the esophagus to do a visual exam of the stomach’s lining and take tissue samples (biopsies). An upper GI series oftens times provides information complementary to endoscopy.
How to prepare
You shouldn’t undergo a barium swallow if you’ve had recent gastric or esophageal surgery, or trauma to your digestive tract unless specifically ordered by your surgeon. You should also skip the procedure if it’s possible you’re pregnant.
Before the procedure:
- Get a list of ingredients for the form of barium sulfate to be used and tell your doctor if you’re allergic to any of them. Also alert your doctor if you’re allergic to simethicone (Gas-X), the fizzy liquid used to inflate your stomach.
- Inform your care team of any medicines (prescription and over-the-counter), vitamins, supplements and herbal products you take, as well as any illnesses or health conditions you have.
- Your doctor will let you know what you may eat and drink the day leading up to the procedure. You may likely be told to avoid eating or drinking after midnight. Be sure to drink lots of water after the procedure.
Risks
Side effects of barium sulfate include:
- Stomach cramps
- Nausea
- Vomiting
- Constipation
- Diarrhea
Nausea and vomiting within a half-hour after swallowing barium are the more prevalent side effects. But overly adverse reactions aren’t common, so if you have strong or persistent side effects after the test, tell your care team. Let them know immediately if you have any of these potentially serious side effects:
- Difficulty breathing or swallowing
- Swelling of your throat
- Confusion
- Bluish skin
- Agitation
- Fast heartbeat
- Red skin, itchiness and hives
Understanding results
The upper GI tract—including the stomach, throat and esophagus—typically has a smooth lining, and fluid and structures move in a certain way. A normal result means the size, shape, physical movement and appearance of the area show no irregularities.
- A barium swallow may detect deviations such as bumps and flat, raised areas indicative of early cancer.
- Larger abnormalities, such as narrowed sections or holes, point to more complex issues and possibly cancer.
Your care team may discuss all of the results of your barium swallow test with you, as well as the need for possible follow-up.
A barium swallow alone is often not enough to make a final diagnosis. Other tests, such as esophagoscopy or other endoscopic or other imaging procedures, may need to be done, so that your care team may view the area in greater detail and examine a tissue biopsy.
90,000 Make an X-ray of the stomach in Moscow
X-ray of the stomach is a diagnostic method for detecting functional disorders and diseases, which makes it possible to assess the size and shape of the organ, the integrity of the walls. This study is informative and easy to complete. The price, in comparison with other diagnostic methods, is low. It can be used provided there is no risk of developing oncological processes in the upper gastrointestinal tract. If available, it is better to use other imaging techniques for the gastric mucosa.
According to the results of diagnostics, it is possible to identify:
- Ulcer;
- Inflammatory processes;
- Stomach cancer.
Complex X-ray examination: X-ray and fluoroscopy of the esophagus, stomach, duodenum 1940
Conditions of the procedure
The Law on Radiation Safety provides for the preliminary conduct of a number of studies: ultrasound, FGDS, laboratory tests.If these techniques do not clarify the situation, an X-ray examination of the stomach is performed.
When to do an X-ray of the stomach:
- Suspected ulcer;
- Inflammation;
- Suspected cancer;
- Deformation of the walls of the stomach;
- Sharp weight loss;
- Feces with blood;
- Anemia;
- Heartburn;
- Pain in the navel.
The procedure is suitable for those who have difficulty swallowing endoscopic devices and have a gag reflex.
Contraindications
Do not take x-rays of the stomach when:
- Pregnancy;
- Gastric bleeding;
- Serious conditions.
The obstacles to using contrast are:
- Wall perforation;
- Intestinal obstruction;
- Sharp abdomen.
The reason for the limitation is irritation of the peritoneum when the contrast enters.
Fluoroscopy of the stomach with barium
Plain X-ray of the gastrointestinal tract does not show changes, since X-rays easily pass through hollow structures, and they are not displayed on the images.
X-ray of the stomach with contrast is intended to identify the area where the movement of the contrast medium is blocked. Places of contrast accumulation indicate a cancerous tumor or pathological narrowing of the intestine.
With the simultaneous introduction of air and barium (double contrast study), it is possible to track the changes occurring in pathologies – cancer, gastritis and ulcers.
Before the analysis, the doctor asks the patient a number of questions in order to determine the technique and act purposefully.
What does X-ray of the stomach and esophagus show?
The procedure will make it possible to track changes in the walls of the stomach and additional shadows in adjacent tissues.
- Clearance change. Narrowing occurs with cancer of the stomach or other organ that compresses the stomach from the outside. Expansion is a sign of diverticula – acquired or congenital.
- Displacement of the stomach. May occur with trauma or hernia.
- Integrity violation. Changes are characteristic of peptic ulcer disease. The location of the defect on the radiograph is visualized as a darkening.
- Filling defects. The place where the contrast has not penetrated may be a tumor, polyp, or neoplasm.
- Thinning of folds is possible with atrophic gastritis.
Esophageal pathologies:
- Narrowing or protrusion of diverticulums;
- Vein dilatation;
- Foreign bodies.
Diseases of the stomach:
- Abnormal suction;
- Duodenal ulcer.
- Cancer.
Advantages of CDB RAS
- Radiography is absolutely safe in terms of radiation exposure, thanks to modern equipment
- High level of professionalism and responsibility of radiologists
- Lack of preliminary preparation and quick obtaining of the result
Preparation for procedure
The preparation rules take into account the patient’s condition.If the functions of the digestive system are not impaired, special training is not carried out. The only condition is that you should not eat for 6-8 hours before the procedure.
If there are disorders of the digestive function, a diet is needed:
- Foods are excluded from the diet, the use of which causes the formation of gas in the intestines;
- you can eat lean meat, fresh eggs, fish, cereals.
- In case of constipation, the patient is prescribed an enema or gastric lavage.
How the procedure is performed
The examination includes examination of the stomach, esophagus and duodenum. The procedure conditionally consists of two parts:
- Fluoroscopy;
- X-ray of the stomach.
Both parts are performed by a radiologist, who then compiles the description.
Algorithm of the procedure:
- Plain X-ray is taken to assess pathology.
- The patient is taking barium. This is necessary, since the density of the organs under study does not differ from those adjacent to them. Acceptance of contrast leads to its gradual passage, which is monitored by a radiologist. A series of shots are taken at different positions.
- When barium sulfate fills the organ completely, the doctor can analyze the correct functioning of the gastrointestinal tract.
- The contrast agent is completely removed 1.5 hours after administration.The doctor uses this time to prepare a report.
Interpretation of results
The description of the information received is carried out by the doctor who observed the process. To obtain a complete picture, one X-ray is not enough.
The result of the examination is an image given to the patient, along with a detailed description.
Sample stomach scan
Where to do an X-ray of the esophagus and stomach with barium
You can make an X-ray of the stomach and intestines at the clinic of the Russian Academy of Sciences (Moscow), for a fee.Diagnostics is carried out using high-quality modern equipment. Qualified and experienced medical professionals will conduct digital research and issue a conclusion. Information about how much the research costs can be obtained by calling the specified phone number.
Diverticula of the esophagus
Deformations of the walls of the esophagus with protrusion of hernia-like formations of a sac-like shape, or diverticula of the esophagus, prevent the normal passage of food from the oral cavity into the stomach and provoke an increased risk of developing inflammatory processes.They can form anywhere along the entire length of the esophagus. There are the following types of diverticula:
- true, involving all layers of the esophagus wall;
- false, formed only by the mucous membrane.
Specialists of ON CLINIC in Ryazan quickly diagnose this very unpleasant disease and prescribe an individually selected effective treatment. Most of the symptoms that bother the patient disappear soon after the onset.
Causes of esophageal diverticula
The walls of the esophagus are deformed for the following reasons:
- congenital abnormalities in the structure of their muscular membrane;
- narrowing of the esophagus for various reasons;
- all kinds of inflammatory processes.
In addition, diverticula are almost inevitably formed when the walls of the esophagus fuse with nearby internal organs.
Symptoms of the presence of esophageal diverticula
Anyone who suffers from the following symptoms can suspect this disease:
- more or less pronounced scratching in the throat;
- dry cough;
- feeling that something is stuck in the throat, “a lump in the throat”;
- feeling of lack of air;
- difficulty swallowing food;
- heart palpitations and pain in the region of the heart;
- changing the timbre of the voice;
- belching of undigested food, sometimes even food that was eaten a few days ago.
If you suspect you have esophageal diverticula, gastroesophageal reflux disease or other abnormalities of the gastrointestinal tract, urgently consult a gastroenterologist – do not wait until the disease progresses!
Diagnostics of the diverticula of the esophagus
A gastroenterologist may suspect this disease in a patient based on the collection of anamnesis during the examination. To confirm the diagnosis, he will most likely prescribe the following studies:
- plain radiography;
- CT of the chest;
- X-ray contrast (using barium) study;
- endoscopic examination, etc.d.
The examination is performed using some of the most reliable medical devices made in Germany, Japan and France. The doctor can prescribe some more tests, which are taken in the laboratory at our medical center.
Treatment of esophageal diverticula in ON CLINIC in Ryazan
It is important not to delay the visit to the doctor, because diverticula of the esophagus is an insidious disease that is dangerous by the development of all sorts of complications :
- perforation of the walls of the esophagus;
- internal bleeding;
- inflammation of the diverticulum;
- the appearance of fistulas of the esophagus;
- angina pectoris;
- suffocation;
- bronchial asthma.
First of all, the gastroenterologist washes the cavities in the walls of the patient’s esophagus using an antiseptic solution and teaches him to empty the diverticula on his own. He prescribes to the patient a diet that is designed to reduce the impact on the affected area. In advanced cases and if there is a risk of complications, surgery can be performed. Our qualified specialists with extensive experience successfully apply effective methods of treating this disease!
Akhalazia
This is the inability of the lower part of the esophageal sphincter to relax the muscles during swallowing, which are combined with disturbances in the motility of the esophagus.If this is alahazia of the cardia, then this is already a chronic disease of the neuromuscular apparatus of the esophagus, which is characterized by violations of the reflex opening of the lower part of the esophageal sphincter at the very entrance to the stomach when swallowing food. This disease is also accompanied by disorders of the peristaltic movements of the esophagus, which makes it difficult for various foods to pass into the stomach. Symptoms of achalasia: This disease can appear at any age. However, most often it begins in people between the ages of 20-40, which only progresses over the years over the course of several months or many years.The main symptom of achalasia is difficulty swallowing liquids and solids. And spasms of the lower esophageal sphincter causes a significant increase in the esophagus, which is higher than this sphincter. In addition, symptoms of achalasia can be chest pain, night cough and regurgitation of the contents of an already enlarged esophagus. In some cases, chest pain may occur when swallowing, and without any significant cause.
Causes of achalasia
The causes of this disease have not yet been fully established, however, experts believe that achalasia occurs due to a mismatch of the nervous regulatory mechanisms that are responsible for the peristaltic movements of the esophagus, as well as for the reflex opening of the lower esophageal sphincter during the approach of the food bolus to it.But according to other studies, malnutrition plays a very large role in the onset of this disease, and insufficient intake of vitamins from group B along with food. In addition, it is assumed that achalasia is associated with damage to the nerve formations in the walls of the esophagus, which are responsible for the functioning of the esophagus.
Diagnostics of achalasia
To diagnose this disease, the doctor prescribes an X-ray of the esophagus, which is done when a person swallows a suspension of barium, which reveals the absence of peristalsis.At this time, the esophagus is dilated, and in some cases to a huge size, but the esophagus is narrowed in the lower sphincter region. In addition, the pressure inside the esophagus is measured, that is, a manometry is performed, which indicates the absence of contractions, and at the same time the pressure in the lower part of the esophageal sphincter is increased, as well as incomplete opening of the esophagus during swallowing food. In addition, the doctor prescribes esophagoscopy, that is, the study of the esophagus with a device that is equipped with a video camera and which shows expansion, but does not reveal a violation of patency.In addition, with the help of an esophagoscope, that is, a flexible fiber-optic medical instrument, the specialist performs a biopsy. And for this, he takes a piece of tissue to examine it under a microscope, and also, in order to exclude other causes of damage to the lower esophagus, it can be scleroderma or esophageal cancer. Moreover, these diseases can also be accompanied by swallowing disorders. It should be noted that achalasia may not always lead to serious health problems.However, the prognosis of the disease can be very bleak if stomach contents enter the lungs, since pulmonary complications are very difficult to treat.
Medical Center “Consultant” – X-ray of the esophagus
X-ray examination of the esophagus is a contrast study aimed at clarifying the presence or absence of pathology of the esophagus, and in the presence of pathology – to clarify the nature of the identified changes.
Esophageal fluoroscopy is a completely safe, non-invasive procedure.Allergic reactions to contrast media are extremely rare due to the fact that barium sulfate is not absorbed from the digestive tract into the blood. The radiation dose received in the process of research on a modern digital apparatus is extremely small and does not lead to the development of negative consequences.
During the examination, the patient is in an upright position and only in rare cases is it necessary to move the table to a horizontal position to obtain the necessary diagnostic information.
During the examination, the patient, on the command of the radiologist, takes a contrast agent – an aqueous suspension of barium sulfate. The consistency of the contrast agent, depending on the objectives of the study, can be from pasty to the consistency of liquid sour cream. The volume of the received contrast is from 50 to 200 ml. Swallowing a contrast suspension that tastes like chalk is generally straightforward.
Indications for fluoroscopy of the esophagus are the following clinical symptoms:
- Atypical chest pain, not associated with pathology of the heart and lungs.
- Suspected gastroesophageal reflux.
- Difficulty swallowing solid or liquid food.
- Pain when swallowing food.
Esophageal fluoroscopy is informative for the following diseases and pathological conditions:
- Suspected or known disorders of esophageal motility.
- Esophagitis.
- Esophageal strictures.
- Varicose veins of the esophagus.
- Suspected perforation of the esophagus (using a water-soluble iodine-containing contrast agent).
- Suspected esophageal diverticulum.
- Tumors of the esophagus.
- Obstruction of the esophagus.
- Operations on the esophagus (assessment of postoperative changes).
- Suspicion of a foreign body of the esophagus.
WARNING! Preparation for research required!
To prepare for the study, it is necessary to abstain from food and liquids for two hours before the study.
Esophageal cancer
Esophageal cancer is a malignant tumor in the esophagus region.
The esophagus is part of the alimentary canal, a long, hollow tube that connects the pharynx to the stomach. Through it, food, entering the oral cavity, and then into the pharynx, reaches the stomach.
The tumor can occur anywhere along the esophagus, but usually forms from the cells lining the inner surface of the esophagus.
Cancer of the esophagus is more common in men than in women. The disease is difficult to treat.
Synonyms Russian
Adenocarcinoma of the esophagus.
English synonyms
Esophageal cancer, Oesophageal cancer, Esophagus cancer, Cancer of the Esophagus.
Symptoms
As a rule, in the early stages, esophageal cancer does not cause any symptoms, they begin to appear when the disease is already actively progressing:
- Difficulty swallowing (usually problems with swallowing liquid food at first),
- weight loss,
- chest pain (compression or burning),
- fatigue,
- choking while eating,
- heartburn,
- cough, hoarseness.
General information about the disease
Esophageal cancer is a malignant tumor in the esophagus region.
The esophagus is part of the alimentary canal, a long, hollow tube that connects the pharynx to the stomach. Through it, food, entering the oral cavity, and then into the pharynx, reaches the stomach. In the upper part of the esophagus is the upper esophageal sphincter, in the lower – the lower esophageal sphincter. Sphincters act as valves, allowing food to pass through the digestive tract in only one direction and preventing aggressive stomach contents from entering the esophagus, pharynx, and oral cavity.
The causes of esophageal cancer have not yet been established.
Types of esophageal cancer are distinguished according to the type of cells that have degenerated into cancerous:
- adenocarcinoma – with this type, glandular cells that produce mucus are reborn into cancerous cells; most often formed in the lower part of the esophagus;
- squamous cell carcinoma – flat, thin cells lining the surface of the esophagus turn into cancerous ones; most often affects the middle of the esophagus and is the most common type of cancer;
- Rare esophageal cancers include choriocarcinoma, lymphoma, melanoma, sarcoma, and small cell carcinoma.
Stages of esophageal cancer:
1) the tumor is located within the upper layer of cells lining the esophagus;
2) the tumor spreads to the deeper layers of the esophagus, to nearby lymph nodes;
3) cancer completely affects the walls of the esophagus, spreads to nearby tissues and lymph nodes;
4) cancer spreads beyond the esophagus, affecting other internal organs.
Complications of esophageal cancer:
- impossibility of food passage through the esophagus;
- pain due to tumor enlargement;
- bleeding in the esophagus – occurs suddenly and is life-threatening;
- significant weight loss – the patient’s intake of fluids and food can be very difficult, which leads to severe weight loss;
- Cough – Cancer can grow through the wall of the esophagus, creating a hole in the trachea (fistula), resulting in a violent cough when swallowing.
Who is at risk?
Chronic irritation of the esophagus contributes to the accumulation of changes in its cells, which can lead to cancer of the esophagus.
At risk are:
- alcohol abusers,
- middle-aged and elderly people,
- smokers,
- suffering from achalasia of the cardia – a disorder of the functioning of the esophagus, causing a violation of the ability of the lower esophageal sphincter to relax;
- who regularly consume very hot food and drinks;
- suffering from gastroesophageal reflux disease (GERD) – a chronic disease caused by repeated reflux of the contents of the stomach or duodenum into the esophagus, which leads to damage to the lower esophagus;
- suffering from bile reflux – a disease in which bile from the duodenum enters the esophagus, stomach or mouth.
90,007 obese people;
The following can also increase the risk of developing esophageal cancer:
- Barrett’s esophagus (one of the serious complications of gastroesophageal reflux disease) – a condition in which an uncharacteristic columnar epithelium is found in the esophageal mucosa instead of a flat stratified epithelium; considered as a precancerous condition of the lower third of the esophagus;
- radiation therapy to the chest or upper abdomen.
Diagnostics
Laboratory diagnostics
Tumor markers – proteins, the level of which may increase in connection with the development of cancer.Some tumor markers are specific for a particular type of cancer, some for several types. However, their level can be increased in a healthy body, so the test for tumor markers is used as an auxiliary method for diagnosing cancer, for diagnosing cancer recurrence and evaluating the effectiveness of its treatment.
The following tumor markers are important in the definition of esophageal cancer:
Other survey methods
- Endoscopy. During endoscopy, the doctor places a thin tube equipped with an endoscope lens into the esophagus through the throat.With the help of an endoscope, irritated areas of the esophagus or cancer are detected. During endoscopy, a biopsy can also be performed – taking the tissues of the esophagus for their subsequent laboratory study.
- X-ray of the esophagus. The patient drinks a thick liquid (barium), due to which the contours of the esophagus and stomach can be examined during an x-ray. In cancer of the esophagus, the relief of its contours changes significantly.
After detecting cancer of the esophagus, its stage, tumor size, and its location are determined.For this, computed tomography (CT) is performed.
Treatment
1. The treatment strategy is determined by the doctor taking into account the type and stage of esophageal cancer.
2. Surgery. Depending on the type and stage of cancer, it is carried out:
- An operation involving the removal of a cancerous tumor and a minimal area of healthy tissue. At an early stage, when the cells of the superficial layer of the esophagus are affected, the operation can be performed using an endoscope.
- An operation to remove part of the esophagus and nearby lymph nodes.
- An operation to remove part of the esophagus and the upper part of the stomach. Nearby lymph nodes are also removed.
3. Chemotherapy. It involves the use of special drugs to destroy cancer cells. It can be used before or after surgery, as well as in combination with radiation therapy.
4. Combination of chemotherapy and radiation therapy. This combination can significantly increase the effectiveness of treatment. Can be used before or after surgery.
5. Nutrition of patients. With severe difficulty in swallowing and exhaustion, tube feeding is used – through a tube inserted into the esophagus or stomach.
6. Radiation therapy. Radiation aimed at destroying cancer cells. In most cases, it is combined with chemotherapy. Can be used before or after surgery.
7. Palliative – supportive – therapy. It is used in the last stages of cancer, when a cure is no longer possible. It is aimed at improving the patient’s quality of life, relieving pain and other symptoms if possible:
- Use of chemotherapy to relieve symptoms.
- Surgical operation aimed at clearing the lumen of the esophagus (bougienage). So that the lumen of the esophagus is not compressed and food can pass through it, stenting can be used – placing a metal tube (stent) into the esophagus.
- Providing patients with nutrients, including with the use of intravenous mixtures.
Prevention
Reduces the risk of developing esophageal cancer:
- smoking cessation,
- moderation in alcohol consumption (causing irritation of the esophagus, it contributes to the development of cancer),
- eating a sufficient amount of fiber (vegetables, fruits, whole grains),
- maintenance of normal weight.
Recommended analyzes
- CA 19-9
- Tumor Marker 2 (TM2) – pyruvate kinase
- Squamous cell carcinoma antigen (SCCA)
- Histological examination of biopsy diagnostic material
Eructations with a sour taste. This symptom is dangerous in that when it appears in a person in a sleeping state, acid masses can penetrate the respiratory tract.
Pain in the sternum, which radiates to the neck and between the shoulder blades.Mostly appear when a person leans forward.
Pain when swallowing solid foods. This is explained by the narrowing of the lumen of the esophagus during the development of stenosis, which is a complication of the disease.
Internal bleeding. The symptom indicates that the esophagitis is severe, and immediate treatment of the disease in the form of surgery is necessary.
FEGDS. This method is the main one for this disease. You should not be afraid of the procedure, it does not last for a long time and only mild discomfort is felt with it. However, it is very important, since without it the doctor cannot be sure that the person is faced with esophagitis.
X-ray examination.During the procedure, a person drinks 250 ml of the Barium mixture and lies down on his back. Then a picture is taken, which will show the reflux of barium into the esophagus from the stomach.
Daily pH metry. Thanks to this study, the doctor determines the daily increase in acidity in the esophagus.
Esophagomanometry. The technique provides an opportunity to determine what state the lower esophageal sphincter is in.
amplipulse therapy relieves pain, eliminates inflammation, improves blood circulation and gastric motility;
with severe acute pain, electrophoresis is performed using ganglion blocking agents;
Microwave therapy is prescribed if the patient, in addition to esophagitis, has abnormalities in the liver or a stomach ulcer;
also for the treatment of esophagitis, applications with sulphide silt mud and electrosleep are often prescribed.
The highest level of specialists: among them are doctors of medical sciences and members of the world’s medical communities, and the average length of service of the clinic’s doctors is 16 years of impeccable work.
Modern expert equipment: diagnostic devices of the medical center were released in 2017 by the world’s leading manufacturers (Pentax and others of the same level).
Impeccable endoscopic diagnostic accuracy thanks to high image resolution of 1.25 million pixels.
Unique technologies for early diagnosis of cancer, including i-scan – virtual chromoendoscopy. With the help of this technology, even the smallest, initial tumor changes can be recognized.
Everything for the patient’s comfort: effective pain relief, including general anesthesia; thin endoscopes less than 10mm in diameter; fast and accurate handling.
Safety: automated disinfection of equipment with quality control, monitoring of vital functions of the patient during research.
Narrow specialization: the medical center deals with diseases of the digestive system, constantly improving in its field. Our specialists are constantly undergoing advanced training, participate in international conferences, trainings and seminars in Russia and Europe.
Convenient location: Petrogradskiy district of St. Petersburg is located not far from the center.It is convenient to get here both by car and by public transport. Chkalovskaya metro station is located very close to the clinic, and also not far from the medical center of St. Petersburg Sportivnaya, Petrogradskaya and Gorkovskaya stations.
90,013 90,000 X-ray proficiency tests (2013) with
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Section 6
X-ray diagnostics of diseases
digestive system and
abdominal organs
001.The folds of the esophageal mucosa are better
identified
a) with tight barium filling
b) after passing the barium lump,
with partial fall of the lumen
c) with double contrast
g) when using relaxants
002. Optimal projection
for X-ray examination
distal esophagus
upright is
a) straight
b) lateral
c) second oblique
g) first oblique
003.Suspect or diagnose
expiratory tracheal stenosis
is possible when contrasting the esophagus in
process
a) standard X-ray
research
b) parietography of the esophagus
c) examination of the esophagus at the time of expiration
g) studies of the esophagus using
pharmacological preparations
004.It is possible to identify a thickening of the esophagus wall
only
a) with double contrast
b) with tight filling with barium mass
c) with pneumomediastinoscopy
g) with parietography
005. The state of peristalsis of the esophagus can be
evaluate objectively with
a) fluoroscopy
b) radiography
c) functional tests
g) X-ray cinematography (video recording)
006.If you suspect the presence
varicose veins of the esophagus
it is advisable to use
a) standard barium suspension
b) thick barium suspension
c) sample with dextran
g) functional tests
007. The easiest way to introduce gas
into the esophagus
for its double contrast
is
a) introduction through a thin probe
b) swallowing air by sick
c) patient swallowing air together
with barium suspension
(in the form of several following each
another sips)
g) taking a soda solution to patients and
citric acid solution
008.When X-ray diagnostics of organic
diseases of the pharynx
the most informative technique is
a) X-ray of the soft tissues of the neck c
lateral projection
b) contrast study of the pharynx with
barium suspension
c) relaxation contrast
pharyngography
g) tomography
009. To identify functional
diseases of the pharynx
the most informative technique is
a) non-contrast radiography (according to
Zemtsov)
b) X-ray in horizontal
position with barium suspension
c) contrast pharyngography with
using functional probes
(swallowing, Müller, Valsalva and
dr.)
g) relaxation pharyngography
010. With relaxation pharyngography
applies
a) Goltsknecht – Jacobson test
b) Mueller’s test
c) Sokolov’s test
g) Brombar’s test
011. Non-contrast radiography of the pharynx and
cervical esophagus
in lateral projection is more often used for
diagnostics
a) tumors of the pharynx and esophagus
b) foreign bodies of the esophagus
c) tumors of the thyroid gland
g) violations of the act of swallowing
012.Ivanova’s technique – Podobed is
a) in the study with barium paste
b) in double contrasting of the esophagus
c) in taking a teaspoon of thick barium
suspended matter
and subsequent washing it off the wall
esophagus water intake
g) in the cottage of cotton wool soaked in barium
suspension
013. X-ray
examination of the esophagus
with barium suspension and the addition of binders
funds
might be useful
a) for cancer of the retrocardiac
b) with varicose veins
c) with diverticula
g) with achalasia of the cardia
014.To identify functional
cardiac insufficiency
(gastroesophageal reflux)
examine patients
most expedient
a) under the conditions of the Mueller test
b) in a horizontal position on the stomach
in the left oblique projection
c) using pharmacological
relaxants
g) at maximum expiration
015.The best conditions for assessing the condition
cardioesophageal junction
arises from research in
horizontal position.
The optimal projection is
a) left nipple (on the back)
b) right nipple (on the back)
c) left scapular (on the stomach)
g) right scapular (on the stomach)
016.The best technique
X-ray examination
the upper stomach is straight and
lateral projection
a) with tight filling in horizontal
supine position
b) with double contrast in
horizontal position on the stomach
c) with tight filling with
contrasting esophagus
g) with an upright position of the patient
017.The structure of the wall of the stomach or intestine
can be identified with
a) parietography
b) double contrast
c) KT
g) ultrasound
018. The most important technical and
methodological conditions
to identify the fine relief of the gastric mucosa
(gastric fields)
is
a) fluoroscopy using
X-ray television
b) special reinforcing screens,
X-ray examination
in conditions of pneumatic relief
c) x-ray tube microfocus,
hard radiation
g) short exposure X-ray,
finely dispersed barium suspension,
metered compression
019.Organ wall thickness
the gastrointestinal tract is studied according to the data of
a) pneumography
b) double contrast
c) parietography
g) angiography
020. To enhance motor function
gastrointestinal tract use
a) atropine
b) metacin
c) sorbitol
g) nitroglycerin
021.For differential diagnosis
functional and organic contractions
area
esophagogastric junction best
effect
give pharmacological preparations from
groups
a) anticholinergics – atropine, metacin
b) nitrites – amyl nitrite, nitroglycerin
c) ganglion blockers – buscopan, etc.
g) cholinomimetics – morphine, etc.
022. For relaxation of the gastrointestinal tract
apply
a) morphine
b) pilocarpine
c) proserpine, acyclidine
g) atropine, metacin, aeron
023. For exophytic formations
gastrointestinal tract
the most informative technique is
a) standard X-ray
research
in the phase of semi-rigid and tight
filling
b) primary double contrasting
c) pneumography
g) pneumoperitoneum
024.The most informative methodology
for detection of masses,
limited by the tissue of the pancreas,
is
a) ultrasound
b) CT
c) relaxation duodenography
g) retrograde pancreatography
025. X-ray technique,
clarifying changes
duodenum for diseases
neighboring organs is
a) study of the stomach and intestines with
barium suspension
b) relaxation duodenography
c) intravenous cholegraphy
g) pneumoperitoneum
026.The advantage of X-ray
small intestine studies
with breakfast food is
a) speed of research
b) a small dose of radiation to the patient
c) physiology, possibility
diagnostics
functional changes, speed
research
g) the ability to diagnose polyps
027.X-ray technique,
allowing to produce
accelerated and fractional contrasting
small intestine
without projection loops, is
a) classical technique
b) Pansdorf’s method
c) L.S. Rosenstrauch’s method
g) Weintraub – Williams method
028. Benefits of enteroclysma
before other techniques
X-ray examination
of the small intestine is that it is
a) does not give complications, does not have
contraindications
b) allows you to study functional
violations
c) allows you to estimate the timing of the passage of barium
intestine
g) allows you to identify areas of narrowing, their
length,
shortens the duration
research
029.The main disadvantage of the Weintraub technique
– Williams
is that it is
a) difficult to perform
b) non-physiological, does not give a clear
mucosal relief
c) requires a long duration
research
g) causes excessive radiation exposure
sick
030. For a detailed study of the relief
small intestine mucosa
the most suitable contrast agent
is
a) ordinary barium suspension
b) water-soluble preparations
c) water-soluble preparations with sorbitol
031.The main technique of X-ray
colon examinations
is
a) oral filling
b) irrigoscopy
c) water enema and supervoltage
radiography
g) Sherigier technique
032. Examination of the colon according to Velin
used for diagnostics
a) any diseases
b) only inflammatory diseases
c) only small tumors
g) all answers are correct
033.With a single double
contrasting colon
diverticula, polyps and fecal matter
can show up in the same way
as a barium rim.
They can be confidently differentiated
a) by the intensity of the rim shadow (more
intensive with diverticulum)
b) along the contours of the rim
(with a clearer external diverticulum,
with polyps – internal)
c) according to the density of the substrate (shadow of the polyp
denser than fecal masses)
034.Colon parietography is used
as an additional method
in patients
a) with ulcerative colitis
b) with common intestinal mesentery
c) with tumor diseases
g) with Hirschsprung’s disease
035. For detailed research
ileocecal area and terminal
small intestine
it is most advisable to use
a) irrigoscopy
b) contrast enteroclysm technique
c) Sherigier’s method
g) oral filling
036.X-ray examination
digestive tract
24 hours after taking barium
suspension is applied
a) to study the pathology of the colon
b) for the study of ileocecal
area
c) to control the timing of the passage of barium
suspended matter
on the gastrointestinal tract,
studying the position of the colon
g) to study the pathology of the small intestine
037.The distal parts of the small intestine are the most
it is advisable to investigate
a) in an upright position of the patient
b) in a horizontal position on the back
c) in a horizontal position on the stomach
g) in a horizontal position on the back with
compression
038. For suspected head cancer
pancreas
with invasion of the common bile duct
or large tumor
duodenal nipples advisable
apply
as a refinement method
a) intravenous cholegraphy
b) infusion intravenous cholegraphy
c) retrograde endoscopic
cholangiography
g) transparietal cholangiography
039.With prolonged secretion of bile from
drainage
after surgery on the biliary tract shows
a) laparoscopy
b) fistulography
c) oral cholecystography
g) intravenous cholegraphy
040. The most informative method
studies of the biliary system
for gallstone disease is
a) ERCP
b) ultrasound
c) intravenous cholecystocholangiography
g) infusion cholegraphy
041.A technique that clarifies the nature
diseases
in the presence of a volumetric process in
pancreas,
complicated by obstructive jaundice,
is
a) X-ray examination
stomach and intestines
with barium suspension
b) relaxation duodenography
c) infusion intravenous cholegraphy
g) retrograde cholangiopancreatography
042.Optimum spacing
between oral administration of contrast
substances
and X-ray examination
gallbladder is
a) 8-10 h
b) 10-12 h
c) 12-15 h
g) 15-20 h
043. Contrasting of the gallbladder at
oral cholecystography
happens
a) due to the ability of the organism
excrete as part of bile
received contrast agent and
gallbladder capabilities
to concentrate contrasting
bile
b) by highlighting the contrast
substances by the wall of the bubble
c) due to selective absorption of protein
from contrasting bile
g) due to a combination of the named processes
044.Increase resolution
methods of intravenous cholangiography
can
a) with the help of pharmacological agents,
enhancing the excretion of contrast
liver substances
b) by intravenous administration of additional
portions of contrast agent
to compensate for its withdrawal
kidneys
c) with the help of dehydration agents
g) using infusion
contrast agent,
or simultaneous introduction
contrast agent
and blood serum albumin
045.Found on plain radiographs
belly
calcifications, depending on their
character and localization
allow you to diagnose various
pathological processes.
Single lumps of lime density in
L2 vertebral body projection
or streak of speckled calcification
to the left and above this level
very characteristic feature
a) calcification of the wall of the abdominal aorta
b) chronic pancreatitis
c) tuberculous mesodenitis
g) urolithiasis
046.Lumpy calcifications
concentric
measuring 1-1.5 cm at the level of the L2 vertebral body or in the form
chains
to the right and below this level is quite
characteristic feature
a) calcification of the mesenteric walls
vessels
b) chronic pancreatitis
c) tuberculous mesodenitis
g) urolithiasis
047.Shell-like calcification
mosaic nature
irregular rounded or spherical
forms in any part of the abdomen –
feature
a) organized hematoma
b) malignant tumor
gastrointestinal tract
c) parasitic cyst
g) teratodermoid tumor
048.Compact calcification of irregular
forms
against the background of the darkening area,
according to palpable mass
in the lower abdomen, allows
speak in favor of
a) organized hematoma
b) malignant tumor
gastrointestinal tract
c) parasitic cyst
g) teratodermoid cyst
049.Compact group
homogeneous lumps of lime
above the pubic articulation due to
a) urinary bladder stones
b) phlebolitis
c) teratodermoid cyst
g) uterine fibroids or adenoma
prostate
050. Small, well-defined shadows.
ring-shaped or linear
with a smooth contour along the bony walls
small pelvis due to
a) calcified lymph nodes
b) ureteral stones
c) phlebolitis
g) ovarian tumors
051.Linear shade of lime density
localized along the spine,
and in lateral projection – in front of it.
In this case,
takes place
a) calcification of the walls of the main
vessels
b) parasites
c) calcified lymph nodes
g) organized drip
052. The same calcifications in the lateral
projection
are superimposed on the shadow of the spine.
Most likely it is
a) calcification of the walls of the main
vessels
b) cysticercosis
c) organized drip
g) traumatic myositis
053. Single lime density shadow
irregular shape up to 1 cm
in the right upper abdomen,
located in lateral projection
anterior to the spine, due to
a) gallbladder stone or common
bile duct
b) kidney stone
c) calcified lymph node
g) calcification in the head
pancreas
054.Same shadow in side projection
superimposed on the spine.
This is
a) stone of the gallbladder or common bile duct
b) kidney or upper third stone
ureter
c) calcification in the head
pancreas
g) calcified lymph node
055. The most reliable diagnostic
spleen data
get
a) with plain radiography of the abdomen
b) for radiography under conditions
pneumoperitoneum
c) with ultrasound
g) with angiography
056.Spleen developmental anomalies
(reshaping, doubling, tailed
spleen)
and its unusual location is the most
you can reliably establish
with
a) plain radiography
b) radiography in conditions
pneumoperitoneum
c) ultrasound
g) scintigraphy
057.Microcalcifications in the spleen and their
nature is better identified with
a) X-ray of the abdomen
b) pneumoperitoneum
c) ultrasound
g) CT
058. X-ray examination in
conditions of pneumoperitoneum
is carried out after the introduction of gas into the abdominal
cavity
a) after 20 min
b) after 30 min
c) after 40 min
g) after 1-1.5 h
059. Abdominal esophagus according to
in relation to the peritoneum is
a) intraperitoneally
b) extraperitoneally
c) mesoperitoneal
060. Stomach in relation to the peritoneum
located
a) intraperitoneally
b) extraperitoneally
c) mesoperitoneal
061.The first part of the duodenum
in relation to the peritoneum
located
a) intraperitoneally
b) extraperitoneally
c) mesoperitoneal
062. The second part of the duodenum
in relation to the peritoneum
located
a) intraperitoneally
b) extraperitoneally
c) mesoperitoneal
063.The third part of the duodenum
in relation to the peritoneum
located
a) intraperitoneally
b) extraperitoneally
c) mesoperitoneal
064. The jejunum in relation to the peritoneum
located
a) intraperitoneally
b) extraperitoneally
c) mesoperitoneal
065.The ileum in relation to
peritoneum is
a) intraperitoneally
b) extraperitoneally
c) mesoperitoneal
066. The cecum in relation to the peritoneum
located
a) intraperitoneally
b) extraperitoneally
c) mesoperitoneal
067.The appendix in relation to
the peritoneum is more often located
a) intraperitoneally
b) extraperitoneally
c) mesoperitoneal
068. The ascending colon in relation to
is located to the peritoneum
a) intraperitoneally
b) extraperitoneally
c) mesoperitoneal
069.The transverse colon in relation to
is located to the peritoneum
a) intraperitoneally
b) extraperitoneally
c) mesoperitoneal
070. The descending colon in relation to
is located to the peritoneum
a) intraperitoneally
b) extraperitoneally
c) mesoperitoneal
071.Sigmoid colon by
in relation to the peritoneum is
a) intraperitoneally
b) extraperitoneally
c) mesoperitoneal
072. The rectum in relation to the peritoneum
located
a) intraperitoneally
b) extraperitoneally
c) mesoperitoneal
g) in different ways, depending on its
department
073.The upper pole of the pharynx is at
level
a) the base of the skull
b) choan
c) the root of the tongue
g) hyoid bone
074. The border between the pharynx and the esophagus
is at
a) arytenoid cartilage
b) 5 cervical vertebra
c) 6 cervical vertebra
g) 7 cervical vertebra
075.Average width of the tubular lumen
esophagus with tight filling
does not exceed
a) 1 centimeter
b) 2 centimeters
in) 3 centimeters
g) 4 centimeters
076. Segmental division of the esophagus along
Brombaru envisages
a) 3 segments
b) 5 segments
c) 7 segments
g) 9 segments
077.Does not change the normal course
contrasting esophagus
a) aorta
b) left main bronchus
c) left atrium
g) azygos vein
078. The main type of motility of the esophagus,
promoting solid food,
is
a) primary peristaltic wave
b) secondary peristaltic wave
c) tertiary contractions
g) total esophageal spasm
079.Cross section at the level of the body T12 vertebra
will pass through all of the below
anatomical structures, except
a) spleen
b) left kidney
c) colon
g) duodenojejunal transition
e) stomach
080. If the patient is frightened or emotionally
upset, his stomach is
a) hypotonic
b) hypertonic
c) intense peristalsis
g) the function of the stomach does not change
081.With moderate distension of the stomach
(and other organs of the gastrointestinal
path) its walls
under normal conditions
a) straightened
b) concave
c) convex
g) polygonal
082. When the stomach is bent, its vault
displaced
a) front
b) back
c) inwardly
g) outwards
083.Antral mucosa folds
stomach
are the result of activities
muscle layer.
The normal direction for them is
a) longitudinal
b) transverse
c) oblique
g) any of the listed depending
from motor phase
084. Stomach peristalsis is normal at
vertical position of the patient
starts at
a) cardia
b) upper half of the body
c) the lower half of the body
g) antrum
085.Under normal conditions, the duration
passage
thin barium suspension head end
intestine is
a) 1 h
b) 3 h
c) 5 h
g) 7 h
086. Mucosal folds are better expressed
a) in the jejunum
b) in the ileum
c) in the duodenum
g) in the jejunum and duodenum
087.Villi of the mucous membrane of the small intestine
intended
a) for better mixing of food and
enzymes
b) to increase the suction area
surface
c) lengthening of the intestine
g) provide greater expansion
lumen
088. The functions of the ileocecal valve
are
a) prevention of premature
content hits
small intestine blind before completion
digestion process
b) prevention of entry
colon flora in the small intestine
c) both of the above
g) none of the listed
089.Of the listed parts of the intestine, not
has mesentery
a) duodenum
b) jejunum
c) ileum
g) appendix of the cecum
090. Mesenteric vessels in the ligament
Treyz pass
a) to the left of the duodeno-jejunal junction
b) in front of the lower horizontal part
duodenum
c) behind the duodenum
g) below the duodenum
091.Indicator of normal total bile
duct is
a) length about 7.5 cm
b) diameter less than 10 mm
in) diameter 15 mm
g) opens into a diverticulum
duodenum
092. Large duodenal nipple in 75%
cases localized
on the medial wall of the duodenum
intestines
a) in its upper horizontal part
b) in the descending department
in) in the lower knee
g) in the lower horizontal part
093.Total serum protein 7 g%,
albumin – above 3.5%, protein
the coefficient is higher than 1.0.
Blood bilirubin level no more than 1.5-2.5
mg%.
These are prerequisites for conducting
a) transparietal cholangiography
b) retrograde transduodenal
cholangiography
c) intravenous cholecystocholangiography
g) manometry of the biliary tract
094.Spleen shape most often
a) rounded
b) oval
c) bean
g) elliptical
095. The contours of the spleen are normal
a) clear
b) wavy
c) fuzzy
g) clear and even only along the edge,
adjacent to the diaphragm
096.Normal right diaphragm dome
is located at the level of the anterior sections of
a) III-IV ribs (VII-VIII thoracic vertebrae)
b) V-VI ribs (IX-X thoracic vertebrae)
c) VII-VIII ribs (XI thoracic vertebra)
g) IX-X ribs (XII thoracic vertebra)
097. The left dome of the diaphragm is located along
towards the right
a) at one level
b) one rib (intercostal space) below
c) one rib (intercostal space) above
g) lower on inspiration, higher on expiration
098.In children, compared to adults,
the diaphragm is
a) above
b) below
c) at the same level
g) there is no definite pattern
099. In older people, compared with
young,
aperture typically located
a) at the same level
b) above
c) below
g) there is no definite pattern
100.Excursion of the diaphragm in normal
conditions
is with moderate and deep inspiration
respectively
a) 0.5 cm and 1 cm
b) 1 cm and 2 cm
c) 2-3 cm and 4 cm
g) 4 cm and 5 cm
101. The amplitude of respiratory movements is studied
using the lattice of I.S. Amosov. Measurements
spend
a) along the inner section of the diaphragm
b) along the central section of the diaphragm
c) for the external department
) in all three departments (in 3 points)
102.Leading X-ray symptom
esophageal atresia is
a) narrowing of the esophagus
b) the presence of a blind bag
c) deformation of the esophagus
g) expansion of the esophagus
103. Characteristic form of esophageal cyst
a) rounded
b) oval or hanging drops
c) wrong
g) type “hourglass”
104.With the right-lying aorta, the vessel is at the level
arc
is thrown over the right main
bronchus.
In this case, the contrasting esophagus
displaced by the aorta
a) anteriorly and to the left
b) anteriorly and to the right
in) to the rear and to the left
g) back and to the right
105. In case of a “pectoral stomach”, the esophagus
always
a) extended
b) shortened
c) deformed
g) tortuous
106.For the common mesentery thin and thick
intestines are not typical
a) absence of duodeno-jejunal bend
b) the location of the loops of the jejunum
in the right half of the abdominal cavity
c) the location of the loops of the jejunum
in the left half of the abdominal cavity
g) the location of the cecum in
central parts of the abdominal cavity
107.Changes in various departments
gastrointestinal tract,
due to the development of fibrous tissue in
submucosal layer
and smooth muscle atrophy, have
place
a) with systemic lupus erythematosus
b) with periarteritis nodosa
c) with scleroderma
g) as an outcome of inflammatory processes
108.Congenital megacolon (disease
Hirschsprung) due to
a) underdevelopment of the muscle layer
b) an excess of ganglionic cells in
muscle layer of the intestine
c) the absence of ganglionic cells in
muscle layer of the intestine
g) segmental atresia of the intestine
109. Pronounced expansion and elongation
distal colon
above the site of local narrowing with
smooth contours
and smooth transitions in a young patient
observed
a) with Crohn’s disease
b) for tuberculosis
c) at megacolon
g) with nonspecific ulcerative colitis
110.Aberrant pancreas more often
localized
a) in the liver
b) in the stomach
c) in the duodenum
g) in the jejunum
111. Radiological symptom of paresis or
paralysis of the pharynx is
a) expansion of the posterior duodenal
soft tissue space
b) deformation of the piriform sinuses
c) delay of contrast medium in
vacuulae and pear-shaped sinuses
g) asymmetric passage
contrast medium through the pharynx
112.The term is “corkscrew
esophagus “reflects
a) developmental anomaly
b) malformation
c) neuromuscular disease
g) inflammatory disease
113. Dysphagia in iron deficiency anemia
(Rossolimo – Bechterew syndrome, Plummer –
Vinson) is a consequence of
functional disorders, narrowings and
membrane formation
in the lumen of the esophagus at the level of
a) cervical
b) tracheal bifurcation
c) the lower third of the esophagus
g) abdominal segment and cardia
114.The abdominal segment of the esophagus, which has
mouse tail view,
is described as characteristic of
a) with scleroderma
b) for cardioesophageal cancer
c) for cardia achalasia
g) with epiphrenal diverticulum
115. Esophagus in the form of beads, distinct,
corkscrew,
pseudodiverticular esophagus is
titles reflect
the same changes in the esophagus, namely
a) multiple diverticula
b) esophagospasm
c) secondary changes as a result
sclerosing mediastinitis
g) varicose veins
116.Paradoxical dysphagia (delayed
liquid food) can occur
a) with esophageal diverticulum
b) for burns of the esophagus
c) for esophagocardial cancer
g) with achalasia of the cardia
117. Dysfunction of the pharynx and aspiration
contrast agent in the trachea
observed
a) with esophageal diverticulum
b) for burns of the esophagus
c) with esophagitis
g) with paresis (paralysis) of the pharynx
118.With paresis of the pharynx on the affected side
rollers and pear-shaped sinuses
a) not filled
b) quickly emptied
c) are filled with barium suspension for a long time,
extended
g) deformed
119. Gas bubble of the stomach with achalasia III-IV degree
a) deformed
b) missing
c) reduced
g) increased
e) reduced or absent
120.Reflux esophagitis should be expected in
sick
a) with hypermotor dyskinesia of the esophagus
b) with hiatal hernia
diaphragm
c) with gastritis and low acidity
gastric juice
g) with stomach cancer
121. The main symptoms of esophagitis can be
received
a) with tight filling of the esophagus with barium
b) with double contrast
c) when studying the relief of the mucous membrane
shell
g) when using pharmacological
preparations
122.With chemical burns of the esophagus
cicatricial narrowing of the lumen more often
observed
a) in the upper third
b) in the middle third
c) in the distal third
g) in places of physiological constrictions
123. Esophageal ulcers are more common on
level
a) cervical
b) upper third (1-3 segments)
c) middle third (4-6 segments)
g) lower third (7-9 segments)
124.Esophageal ulcers are more often located
a) on the front wall
b) on the back wall
c) on the side walls
g) on the back and side walls
125. Esophageal ulcers occur
a) with brain disorders, after
operations, or as a result of injury
b) for hernia of the esophageal opening
diaphragm,
stomach or duodenal ulcers,
islet heterotopy
gastric mucosa in the esophagus and
dr.
c) for diabetes
g) accompany varicose veins
veins of the esophagus
126. The most frequent complication of ulcers
esophagus is
a) malignancy
b) cicatricial narrowing of the lumen
c) perforation of the esophageal wall
g) bleeding
127. Persistent circular narrowing of the middle and
lower third of the esophagus
more than 6 cm long with
suprastenotic extension
and pocket-like overhanging of the wall on
border with narrowing –
characteristic radiological manifestations
a) for endophytic cancer
b) with cicatricial narrowing after a burn
c) with esophagospasm
g) with sclerosing mediastinitis
128.Esophageal perforation is more common
watch
a) for chemical burns
b) with scleroderma
c) with achalasia
g) with varicose veins
129. Complication of hiatal hernia
the diaphragm is
a) gastritis
b) reflux esophagitis
c) neuromuscular disorders of the esophagus
g) esophageal cancer
130.Cicatricial changes in the esophagus with
shortening of its distal part
and fixed esophageal hernia
diaphragm holes
are most often a consequence of
a) diabetes
b) achalasia of the cardia
c) ulcerative reflux esophagitis
g) gastric resection
131. Radiological signs:
additional shadow on the background
mediastinum,
marginal defect of filling the esophagus with
two or more contours,
no wall rigidity, preservation
mucous membranes are characterized by
a) for polypoid cancer of the esophagus
b) to increase the bifurcation
lymph nodes
c) for non-epithelial tumor
g) for an abnormally located right
subclavian artery
132.Persistent narrowing of the esophagus in length
up to 5 cm
with uneven contours and rigid
walls,
violation of the patency of the esophagus,
no normal relief
mucous membrane with a symptom of a broken fold –
radiological symptoms
a) esophagospasm
b) cicatricial stricture
c) endophytic cancer
g) secondary changes in the esophagus with
chronic mediastinitis
133.Among benign tumors
esophagus more common
a) adenoma
b) papilloma
c) leiomyoma
g) fibroma
134. The most pronounced suprastenotic
dilatation of the esophagus
to be expected
a) with polypoid cancer
b) with endophytic cancer of the upper third
esophagus
c) with endophytic cancer of the lower third
esophagus
g) with cup-like carcinoma
135.Esophageal cancer is more common
a) in the upper part of the esophagus
b) in the middle part of the esophagus
c) in the lower part of the esophagus
g) in the abdominal segment of the esophagus
136. Methodology that specifies the distribution
tumor infiltration of the esophageal wall,
is
a) multi-projection study
esophagus with barium suspension
b) double contrasting of the esophagus
c) computed tomography
g) examination of the esophagus with
pharmacological relaxants
137.Long range of changes
esophagus
as multiple defects with areas
wall stiffness
most typical
a) for polyps
b) for cancer
c) for sarcoma
g) for varicose veins
138. Traction diverticula more often
are found
a) in the cervical esophagus
b) in the ampullar part of the esophagus
c) in the abdominal segment
g) at the level of tracheal bifurcation
139.Diverticula of the esophagus, formed when
chronic mediasthenitis,
are called
a) Zenker’s
b) epiphrenal
v) pulse
g) traction
140. Zenker diverticula are formed
a) on the anterior wall of the esophagus
b) on the posterior wall of the esophagus
c) on the side walls of the esophagus
g) on the front and side walls
esophagus
141.The reason for the development of bifurcation
traction diverticula of the esophagus
is
a) right-lying aortic arch
b) aortic aneurysm
c) compression of the esophagus with an enlarged left
atrium
for heart defects
g) bronchoadenitis
142. Intra-wall (incomplete) diverticula
can occur in the esophagus
a) with sclerosing mediasthenitis
b) with alkaline esophagitis, cicatricial
esophageal strictures
c) for primary tuberculosis, moniliasis
g) with a steady increase
intraluminal pressure
143.Most frequent location
diverticula of the esophagus
on its back surface
a) in the inter-aortobronchial segment
b) in the pharyngeal-esophageal junction
c) in the supraphrenic segment
g) in the interbronchial department
144. Most frequent location
diverticula of the esophagus
on its left antero-lateral wall
a) in the inter-aortobronchial segment
b) in the pharyngeal-esophageal junction
c) in the supraphrenic segment
g) in the interbronchial department
145.Most frequent location
diverticula of the esophagus
on its right antero-lateral wall
a) in the inter-aortobronchial segment
b) in the pharyngeal-esophageal junction
c) in the supraphrenic segment
g) in the interbronchial department
146. Most frequent location
diverticula of the esophagus
on its front or side walls
a) in the inter-aortobronchial segment
b) in the pharyngeal-esophageal junction
c) in the supraphrenic segment
g) in the subbronchial department
147.Esophageal candidiasis is characterized by
its “disheveled” contour
a) in the middle and lower thirds of the chest
department of the esophagus.
Ulceration and
knotty filling defects
b) is most pronounced in the middle and lower
thirds of the esophagus.
Defects on contours and relief
serpentine,
change size and shape in
depending on the position of the patient
and breathing phases
c) in the lower third of the esophagus and usually
matched
with hiatal hernia
148.Peptic esophagitis is characterized by
a) “disheveled” contour
in the middle and lower third of the thoracic
department of the esophagus.
Ulceration and
filling defects
b) defects look like a serpentine, change
size and shape
depending on the position of the patient,
breathing phases
and most pronounced in average and
lower third of the esophagus
c) signs are usually combined
with hiatal hernia
diaphragm
and observed in the lower third
esophagus
149.Varicose veins of the esophagus expressed by
a) “disheveled” contour
in the middle and lower third of the thoracic
department of the esophagus.
Ulceration may occur
b) defects look like a serpentine, change
size and shape
depending on the position of the patient,
breathing phases and localized
in the middle and lower third of the esophagus
c) the most frequent localization in the lower
third of the esophagus
and usually associated with a hernia
esophageal opening of the diaphragm
150.Horizontal liquid level on background
mediastinum
is not observed with the following changes
esophagus
a) diverticulum
b) varicose veins
c) congenital short esophagus
g) achalasia of the cardia
Answers –
Chapter
6
X-ray diagnostics
diseases
digestive system
and
abdominal organs
001 | 040 | 079 | 118 |
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007 | 046 | 085 | 124 |
008 | 047 | 086 | 125 |
009 | 048 | 087 | 126 |
010 | 049 | 088 | 127 |
011 | 050 | 089 | 128 |
012 | 051 | 090 | 129 |
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016 | 055 | 094 | 133 |
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022 | 061 | 100 | 139 |
023 | 062 | 101 | 140 |
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ᐈ Diagnostics and treatment of reflux esophagitis in St. Petersburg
Reflux esophagitis is one of the most common gastrointestinal diseases. The cause of its occurrence is considered to be inflammation of the mucous membrane of the esophagus, which develops due to the penetration of hydrochloric acid into the esophagus. Numerous studies indicate that esophagitis is diagnosed in 40-60% of the population, and every year the indicator increases significantly.
If the disease is not treated, dangerous complications may arise, therefore our doctors recommend seeking qualified help when the first symptoms appear.
Reflux esophagitis – what is it?
Esophagitis, if translated from the ancient Greek language, means “inflammation of the esophagus.” Reflux is a Latin word that translates as “backward flow.” When a disease develops, both concepts reflect the process. Namely, there is a movement of food masses, gastric juice and enzymes from the stomach back into the esophagus, which causes irritation and inflammation of the mucous membrane.
Both adults and children are at risk of gastric contents into the esophagus, therefore, if a problem occurs, it is necessary to seek medical help.
The stomach and esophagus are separated by a sphincter, due to which reflux is extremely rare and lasts no more than 5 minutes, which is considered normal. A deviation is when this process is repeated every day and lasts at least an hour.
Symptoms and Manifestations
When gastric contents enter the lining of the esophagus, the person experiences a burning sensation in the esophagus.This is due to the fact that acid provokes tissue burns.
Our doctors say that if reflux esophagitis develops for a long time and remains untreated, then the symptoms become more pronounced, and the following manifestations of the disease also occur:
Diagnostics
The following techniques are used to diagnose reflux esophagitis:
Treatment
To make the treatment of reflux esophagitis as effective as possible, our doctors have a comprehensive approach to the problem, and recommend that patients adhere to a diet, take medications and undergo physiotherapy procedures.
Treatment of esophagitis is carried out by taking proton pump blockers. The drugs of the first group normalize the functioning of the gastric glands and mucous membranes of the digestive system.Also, doctors prescribe these drugs to patients in order to further protect the walls of the esophagus, stomach and duodenum. If blockers are used correctly, then the recovery of the affected areas of the mucous membranes occurs faster.
Antacids
Medicines of this group eliminate the manifestations of heartburn. After taking them, the main substances begin to affect the body after 15 minutes. Antacid therapy for esophagitis is aimed at reducing the amount of hydrochloric acid, due to which a person experiences a burning sensation and pain in the chest.
Alginates and prokinetics
With the help of alginates, hydrochloric acid is neutralized, the gastric walls are covered with an additional protective layer, and the work of the gastrointestinal tract is normalized. Thanks to prokinetics, the motor function of the stomach, muscles and the upper parts of the small intestine improves.
Physiotherapy procedures
In addition to taking medications, the treatment of esophagitis includes physiotherapy procedures:
Why you need to contact our clinic
Our clinic employs exclusively highly qualified specialists who systematically improve their skills, study new drug prescription regimens, and highly specialized equipment.
By choosing our clinic and making an appointment with a specialist, you will be provided with an individual comprehensive approach to diagnostics and treatment, which will take place in the most comfortable conditions, as well as generally affordable prices.
We recommend:
Appointment of a gastroenterologist
FGDS
FGDS with the advice of a leading specialist
Test for the likelihood of stomach cancer
Are you over 45 years old?
Not really
Have your relatives had cancer?
Not really
Do you have chronic diseases of the gastrointestinal tract:
– chronic gastritis,
– peptic ulcer,
– chronic colitis and other inflammatory bowel diseases,
– Crohn’s disease,
– ulcerative colitis,
– previously identified polyps of the stomach and intestines,
– identified submucosal epithelial formations of the gastrointestinal tract?
Not really
Have you had stomach and intestinal surgeries?
Not really
Do you have cicatricial adhesive changes in the gastrointestinal tract?
Not really
Do you smoke (more than 1 cigarette per day)?
Not really
Do you allow for errors in your diet (low consumption of fruits and vegetables, high consumption of meat and animal fats)?
Not really
You have at least one of the following symptoms:
– overweight,
– difficulty swallowing,
– irritability,
– pallor of the skin,
– chest pain,
– unmotivated weakness,
– sleep disturbance,
– loss of appetite,
– bad breath,
– belching,
– nausea and / or vomiting,
– feeling of heaviness in the abdomen,
– changes in stool (constipation and / or diarrhea),
– traces of blood in the stool,
– abdominal pain.
Not really
Make an appointment
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Our professionalism is always on guard for your health.
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