Dysphagia barium swallow: Difference between revisions

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==Barium Swallow==
==Barium Swallow==
Barium swallow study findings for dysphagia are as follows:<ref name="ChenOtt1985">{{cite journal|last1=Chen|first1=Yu Men|last2=Ott|first2=David J.|last3=Gelfand|first3=David W.|last4=Munitz|first4=H. Alexander|title=Multiphasic examination of the esophagogastric region for strictures, rings, and hiatal hernia: Evaluation of the individual techniques|journal=Gastrointestinal Radiology|volume=10|issue=1|year=1985|pages=311–316|issn=0364-2356|doi=10.1007/BF01893119}}</ref><ref>Rosenbek, J. C., Robbins J. A., Roecker, E. B., Coyle, J. L., & Wood, J. L.  (1996).  A penetration aspiration scale. "Dysphagia, 11," 93-98.</ref><ref name="LogemannPauloski1992">{{cite journal|last1=Logemann|first1=Jeri A.|last2=Pauloski|first2=Barbara Roa|last3=Rademaker|first3=Alfred|last4=Cook|first4=Barbara|last5=Graner|first5=Darlene|last6=Milianti|first6=Frank|last7=Beery|first7=Quinter|last8=Stein|first8=David|last9=Bowman|first9=Julia|last10=Lazarus|first10=Cathy|last11=Heiser|first11=Mary Anne|last12=Baker|first12=Theresa|title=Impact of the diagnostic procedure on outcome measures of swallowing rehabilitation in head and neck cancer patients|journal=Dysphagia|volume=7|issue=4|year=1992|pages=179–186|issn=0179-051X|doi=10.1007/BF02493468}}</ref><ref name="LevineRubesin2017">{{cite journal|last1=Levine|first1=Marc S.|last2=Rubesin|first2=Stephen E.|title=History and Evolution of the Barium Swallow for Evaluation of the Pharynx and Esophagus|journal=Dysphagia|volume=32|issue=1|year=2017|pages=55–72|issn=0179-051X|doi=10.1007/s00455-016-9774-y}}</ref>
'''Modified barium swallow study'''
*Conducted by a speech pathologist in conjunction with a radiologist:<ref name="ChenOtt1985">{{cite journal|last1=Chen|first1=Yu Men|last2=Ott|first2=David J.|last3=Gelfand|first3=David W.|last4=Munitz|first4=H. Alexander|title=Multiphasic examination of the esophagogastric region for strictures, rings, and hiatal hernia: Evaluation of the individual techniques|journal=Gastrointestinal Radiology|volume=10|issue=1|year=1985|pages=311–316|issn=0364-2356|doi=10.1007/BF01893119}}</ref><ref>Rosenbek, J. C., Robbins J. A., Roecker, E. B., Coyle, J. L., & Wood, J. L.  (1996).  A penetration aspiration scale. "Dysphagia, 11," 93-98.</ref><ref name="LogemannPauloski1992">{{cite journal|last1=Logemann|first1=Jeri A.|last2=Pauloski|first2=Barbara Roa|last3=Rademaker|first3=Alfred|last4=Cook|first4=Barbara|last5=Graner|first5=Darlene|last6=Milianti|first6=Frank|last7=Beery|first7=Quinter|last8=Stein|first8=David|last9=Bowman|first9=Julia|last10=Lazarus|first10=Cathy|last11=Heiser|first11=Mary Anne|last12=Baker|first12=Theresa|title=Impact of the diagnostic procedure on outcome measures of swallowing rehabilitation in head and neck cancer patients|journal=Dysphagia|volume=7|issue=4|year=1992|pages=179–186|issn=0179-051X|doi=10.1007/BF02493468}}</ref><ref name="LevineRubesin2017">{{cite journal|last1=Levine|first1=Marc S.|last2=Rubesin|first2=Stephen E.|title=History and Evolution of the Barium Swallow for Evaluation of the Pharynx and Esophagus|journal=Dysphagia|volume=32|issue=1|year=2017|pages=55–72|issn=0179-051X|doi=10.1007/s00455-016-9774-y}}</ref>
*Different consistencies of liquid and food mixed with [[barium]] sulfate are fed to the patient by spoon, cup or syringe, and x-rayed using videofluoroscopy 
*Penetration aspiration scale describes the disordered physiology of a person's swallow using the numbers 1-8
'''Findings'''


===Oropharyngeal Dysphagia===
Barium swallow helps in diagnosing the underling etiology of patients presenting with dysphagia such as:
*Modified barium swallow study
**Conducted by a speech pathologist in conjunction with a radiologist 
**Different consistencies of liquid and food mixed with [[barium]] sulfate are fed to the patient by spoon, cup or syringe, and x-rayed using videofluoroscopy 
**Penetration aspiration scale describes the disordered physiology of a person's swallow using the numbers 1-8
===Esophageal Dysphagia===
The following conditions causing dysphagia require a barium swallow:
* History of surgery for laryngeal or esophageal cancer
* History of surgery for laryngeal or esophageal cancer
* History of radiation or irritating injury
* History of radiation or irritating injury
* [[Achalasia]]
* [[Achalasia]]
* [[Zenker's diverticulum]], a barium swallow should be performed first instead of endoscopy to prevent any perforation.  
* [[Zenker's diverticulum]], a barium swallow should be performed first instead of endoscopy to prevent any perforation.  
* Achalasia
* [[Achalasia]]
* Stricture
* [[Stricture]]
===Images===
===Diffuse esophageal spasm barium swallow===
[[Image:DES radio.png|frame|center|Barium swallow appearance of DES<br>Source:By Nevit Dilmen [CC BY-SA 3.0 (https://creativecommons.org/licenses/by-sa/3.0)]]
[[Image:DES radio.png|frame|center|Barium swallow appearance of DES<br>Source:By Nevit Dilmen [CC BY-SA 3.0 (https://creativecommons.org/licenses/by-sa/3.0)]]
===Achalasia barium swallow===
 
[[Image:Acha.jpg|center|200px|thumb|Case courtesy of Dr Mario  Umana, Radiopaedia.org, rID: 38071]]
[[Image:Acha.jpg|center|200px|thumb|Case courtesy of Dr Mario  Umana, Radiopaedia.org, rID: 38071]]
===Esophageal cancer barium swallow===
 
[[Image:ec1.jpg|thumb|center|500px|Source: Barium swallow showing esophageal cancer. Case courtesy of Dr Andrew Dixon, <a href="https://radiopaedia.org/">Radiopaedia.org</a>. From the case <a href="https://radiopaedia.org/cases/9907">rID: 9907</a>]]
[[Image:ec1.jpg|thumb|center|500px|Source: Barium swallow showing esophageal cancer. Case courtesy of Dr Andrew Dixon, <a href="https://radiopaedia.org/">Radiopaedia.org</a>. From the case <a href="https://radiopaedia.org/cases/9907">rID: 9907</a>]]



Revision as of 16:55, 23 February 2018

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Feham Tariq, MD [2], Hamid Qazi, MD, BSc [3]

Overview

Among patients with dysphagia, barium study is considered the preferred method for evaluating patients as it allows assessment of function of the upper gastrointestinal tract and morphology.

Barium Swallow

Modified barium swallow study

  • Conducted by a speech pathologist in conjunction with a radiologist:[1][2][3][4]
  • Different consistencies of liquid and food mixed with barium sulfate are fed to the patient by spoon, cup or syringe, and x-rayed using videofluoroscopy
  • Penetration aspiration scale describes the disordered physiology of a person's swallow using the numbers 1-8

Findings

Barium swallow helps in diagnosing the underling etiology of patients presenting with dysphagia such as:

  • History of surgery for laryngeal or esophageal cancer
  • History of radiation or irritating injury
  • Achalasia
  • Zenker's diverticulum, a barium swallow should be performed first instead of endoscopy to prevent any perforation.
  • Achalasia
  • Stricture
Barium swallow appearance of DES
Source:By Nevit Dilmen [CC BY-SA 3.0 (https://creativecommons.org/licenses/by-sa/3.0)
Case courtesy of Dr Mario Umana, Radiopaedia.org, rID: 38071
Source: Barium swallow showing esophageal cancer. Case courtesy of Dr Andrew Dixon, <a href="https://radiopaedia.org/">Radiopaedia.org</a>. From the case <a href="https://radiopaedia.org/cases/9907">rID: 9907</a>

References

  1. Chen, Yu Men; Ott, David J.; Gelfand, David W.; Munitz, H. Alexander (1985). "Multiphasic examination of the esophagogastric region for strictures, rings, and hiatal hernia: Evaluation of the individual techniques". Gastrointestinal Radiology. 10 (1): 311–316. doi:10.1007/BF01893119. ISSN 0364-2356.
  2. Rosenbek, J. C., Robbins J. A., Roecker, E. B., Coyle, J. L., & Wood, J. L. (1996). A penetration aspiration scale. "Dysphagia, 11," 93-98.
  3. Logemann, Jeri A.; Pauloski, Barbara Roa; Rademaker, Alfred; Cook, Barbara; Graner, Darlene; Milianti, Frank; Beery, Quinter; Stein, David; Bowman, Julia; Lazarus, Cathy; Heiser, Mary Anne; Baker, Theresa (1992). "Impact of the diagnostic procedure on outcome measures of swallowing rehabilitation in head and neck cancer patients". Dysphagia. 7 (4): 179–186. doi:10.1007/BF02493468. ISSN 0179-051X.
  4. Levine, Marc S.; Rubesin, Stephen E. (2017). "History and Evolution of the Barium Swallow for Evaluation of the Pharynx and Esophagus". Dysphagia. 32 (1): 55–72. doi:10.1007/s00455-016-9774-y. ISSN 0179-051X.

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