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Marc S. Levine - One of the best experts on this subject based on the ideXlab platform.
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Ten Questions About Barium Esophagography and Dysphagia
Gastroenterology clinics of North America, 2018Co-Authors: Marc S. LevineAbstract:The barium esophagogram is a global test for patients with dysphagia that can simultaneously detect morphologic abnormalities in the pharynx and esophagus, pharyngeal swallowing dysfunction, esophageal dysmotility, and gastroesophageal reflux. The barium esophagram is an inexpensive, noninvasive, and widely available procedure that can serve as the initial diagnostic test for dysphagia and facilitate selection of other diagnostic studies such as endoscopy. This article addresses 10 questions about barium Esophagography and dysphagia that should help gastroenterologists gain a better perspective about the utility of barium studies in this clinical setting.
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Consensus Statement of Society of Abdominal Radiology Disease-Focused Panel on Barium Esophagography in Gastroesophageal Reflux Disease.
AJR. American journal of roentgenology, 2016Co-Authors: Marc S. Levine, Stephen E. Rubesin, David A. Katzka, Laura R. Carucci, David J. Disantis, David M. Einstein, Mary T. Hawn, Bonnie Martin-harris, Desiree E. Morgan, Francis J. ScholzAbstract:OBJECTIVE. The Society of Abdominal Radiology established a panel to prepare a consensus statement on the role of barium Esophagography in gastroesophageal reflux disease (GERD), as well as recommended techniques for performing the fluoroscopic examination and the gamut of findings associated with this condition. CONCLUSION. Because it is an inexpensive, noninvasive, and widely available study that requires no sedation, barium Esophagography may be performed as the initial test for GERD or in conjunction with other tests such as endoscopy.
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Comparison between Esophagography and chest computed tomography for evaluation of leaks after esophagectomy and gastric pull-through.
Journal of thoracic imaging, 2013Co-Authors: Joshua E. Lantos, Marc S. Levine, Stephen E. Rubesin, Charles T. Lau, Drew A. TorigianAbstract:Purpose:To assess the diagnostic performance of Esophagography and chest computed tomography (CT) for detecting leaks after esophagectomy and gastric pull-through.Materials and Methods:Our database revealed 29 patients who had undergone Esophagography and chest CT after esophagectomy. The sensitivit
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Radiographic Diagnosis of Eosinophilic Esophagitis
Eosinophilic Esophagitis, 2011Co-Authors: Marc S. Levine, David A. KatzkaAbstract:The diagnosis of eosinophilic esophagitis (EoE) continues to evolve as we gain a better understanding of this fascinating disease. EoE initially was diagnosed pathologically by a high number of intraepithelial eosinophils in the esophagus, but the diagnosis is now based on several histologic parameters in combination with key demographic, clinical, and endoscopic features. Despite numerous endoscopic studies on EoE, the role of barium Esophagography in diagnosing this disease has received little attention in the gastroenterology literature. Lack of interest in Esophagography is related to recognized advantages of endoscopy for directly visualizing the esophageal mucosa and obtaining biopsy specimens as well as the desire to avoid ionizing radiation in patients with dysphagia. We believe, however, that endoscopy and barium Esophagography should be regarded as complementary rather than competitive techniques for the evaluation of patients with dysphagia and possible EoE. In such cases, the barium study provides a global examination that can be used not only to detect esophagitis or strictures, but also to assess swallowing function, esophageal motility, and the presence and degree of gastroesophageal reflux disease (GERD) in patients with other conditions masquerading as EoE based on the clinical presentation.
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Morphology of the Esophagus
Dysphagia, 2011Co-Authors: Marc S. Levine, Arastoo VossoughAbstract:Barium Esophagography is an invaluable radiologic technique for detecting a host of morphologic abnormalities in the esophagus. Double-contrast barium studies are particularly well suited for diagnosing reflux esophagitis and its complications, including peptic strictures and Barrett’s esophagus. Double-contrast Esophagography is also useful for detecting infectious esophagitis and for differentiating the underlying causes, including Candida albicans, the herpes simplex virus, cytomegalovirus, and human immunodeficiency virus. Barium studies can also facilitate the diagnosis of drug-induced esophagitis, eosinophilic esophagitis, and other less common forms of esophagitis. In patients with dysphagia, barium Esophagography is a sensitive test for detecting the two common malignant tumors of the esophagus—squamous cell carcinoma and adenocarcinoma. Finally, Esophagography can be used to diagnose other morphologic abnormalities in the esophagus, including webs, rings, diverticula, varices, foreign body impactions, fistulas, and perforation. All of these conditions are discussed in the following chapter.
David A. Katzka - One of the best experts on this subject based on the ideXlab platform.
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Consensus Statement of Society of Abdominal Radiology Disease-Focused Panel on Barium Esophagography in Gastroesophageal Reflux Disease.
AJR. American journal of roentgenology, 2016Co-Authors: Marc S. Levine, Stephen E. Rubesin, David A. Katzka, Laura R. Carucci, David J. Disantis, David M. Einstein, Mary T. Hawn, Bonnie Martin-harris, Desiree E. Morgan, Francis J. ScholzAbstract:OBJECTIVE. The Society of Abdominal Radiology established a panel to prepare a consensus statement on the role of barium Esophagography in gastroesophageal reflux disease (GERD), as well as recommended techniques for performing the fluoroscopic examination and the gamut of findings associated with this condition. CONCLUSION. Because it is an inexpensive, noninvasive, and widely available study that requires no sedation, barium Esophagography may be performed as the initial test for GERD or in conjunction with other tests such as endoscopy.
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The Role of Barium Esophagography in an Endoscopy World
Gastrointestinal endoscopy clinics of North America, 2014Co-Authors: David A. KatzkaAbstract:Barium Esophagography, although an old test, remains important to the understanding of esophageal physiology and diagnosis of esophageal disorders. It provides additive and/or confirmatory information to endoscopy and is the more accurate means of yielding diagnosis. Barium Esophagography allows correlation of symptoms with barium findings and with varied textures substances. It allows, particularly for oropharyngeal dysfunction, implementation therapeutic maneuvers and instructions while testing. The caveat to maintaining the benefits of barium Esophagography is continuing to promote and support expertise from our radiologists in performing these studies, which has been challenged by our cost-efficient and high-tech medical society.
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Radiographic Diagnosis of Eosinophilic Esophagitis
Eosinophilic Esophagitis, 2011Co-Authors: Marc S. Levine, David A. KatzkaAbstract:The diagnosis of eosinophilic esophagitis (EoE) continues to evolve as we gain a better understanding of this fascinating disease. EoE initially was diagnosed pathologically by a high number of intraepithelial eosinophils in the esophagus, but the diagnosis is now based on several histologic parameters in combination with key demographic, clinical, and endoscopic features. Despite numerous endoscopic studies on EoE, the role of barium Esophagography in diagnosing this disease has received little attention in the gastroenterology literature. Lack of interest in Esophagography is related to recognized advantages of endoscopy for directly visualizing the esophageal mucosa and obtaining biopsy specimens as well as the desire to avoid ionizing radiation in patients with dysphagia. We believe, however, that endoscopy and barium Esophagography should be regarded as complementary rather than competitive techniques for the evaluation of patients with dysphagia and possible EoE. In such cases, the barium study provides a global examination that can be used not only to detect esophagitis or strictures, but also to assess swallowing function, esophageal motility, and the presence and degree of gastroesophageal reflux disease (GERD) in patients with other conditions masquerading as EoE based on the clinical presentation.
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Short-segment Barrett's esophagus: findings on double-contrast Esophagography in 20 patients.
AJR. American journal of roentgenology, 2001Co-Authors: Alvin J. Yamamoto, Marc S. Levine, Stephen E. Rubesin, David A. Katzka, Emma E. Furth, Igor LauferAbstract:OBJECTIVE. The purpose of this study was to determine the findings of short-segment Barrett's esophagus on double-contrast Esophagography.MATERIALS AND METHODS. A review of pathology and endoscopy data revealed 142 patients with short-segment Barrett's esophagus, which was defined as columnar epithelium in the distal esophagus extending 3 cm or less above the gastroesophageal junction at endoscopy with histopathologic confirmation of intestinal metaplasia. Twenty of these patients underwent double-contrast Esophagography. These 20 patients comprised our study group. The original radiology reports and images were reviewed to determine the findings on double-contrast Esophagography. Medical records were also reviewed to determine the clinical findings and treatment.RESULTS. Double-contrast esophagrams revealed hiatal hernias in 18 patients (90%), gastroesophageal reflux in 16 (80%), reflux esophagitis in seven (35%), peptic scarring or strictures in 11 (55%), and a reticular mucosal pattern in none. A total...
Stephen E. Rubesin - One of the best experts on this subject based on the ideXlab platform.
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Consensus Statement of Society of Abdominal Radiology Disease-Focused Panel on Barium Esophagography in Gastroesophageal Reflux Disease.
AJR. American journal of roentgenology, 2016Co-Authors: Marc S. Levine, Stephen E. Rubesin, David A. Katzka, Laura R. Carucci, David J. Disantis, David M. Einstein, Mary T. Hawn, Bonnie Martin-harris, Desiree E. Morgan, Francis J. ScholzAbstract:OBJECTIVE. The Society of Abdominal Radiology established a panel to prepare a consensus statement on the role of barium Esophagography in gastroesophageal reflux disease (GERD), as well as recommended techniques for performing the fluoroscopic examination and the gamut of findings associated with this condition. CONCLUSION. Because it is an inexpensive, noninvasive, and widely available study that requires no sedation, barium Esophagography may be performed as the initial test for GERD or in conjunction with other tests such as endoscopy.
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Comparison between Esophagography and chest computed tomography for evaluation of leaks after esophagectomy and gastric pull-through.
Journal of thoracic imaging, 2013Co-Authors: Joshua E. Lantos, Marc S. Levine, Stephen E. Rubesin, Charles T. Lau, Drew A. TorigianAbstract:Purpose:To assess the diagnostic performance of Esophagography and chest computed tomography (CT) for detecting leaks after esophagectomy and gastric pull-through.Materials and Methods:Our database revealed 29 patients who had undergone Esophagography and chest CT after esophagectomy. The sensitivit
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Barium Esophagography: A Study for All Seasons
Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association, 2008Co-Authors: Marc S. Levine, Stephen E. Rubesin, Igor LauferAbstract:Although a variety of diagnostic procedures are often performed on patients with pharyngeal or esophageal symptoms, barium Esophagography is a noninvasive, inexpensive, and readily available test that can simultaneously evaluate swallowing function, esophageal motility, gastroesophageal reflux, and a host of structural abnormalities in the pharynx and esophagus. This article reviews the role of barium Esophagography for assessing swallowing function, morphologic abnormalities of the pharynx (diverticula, webs, and carcinoma), esophageal motility disorders (achalasia and diffuse esophageal spasm), and morphologic abnormalities of the esophagus (reflux esophagitis, Barrett's esophagus, infectious esophagitis, drug-induced esophagitis, eosinophilic esophagitis, Schatzki's ring, and esophageal carcinoma).
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Esophageal stents: findings on Esophagography in 46 patients.
AJR. American journal of roentgenology, 2006Co-Authors: Gregory S. Anderson, Marc S. Levine, Stephen E. Rubesin, Igor Laufer, Gregory G. Ginsberg, Michael L. KochmanAbstract:OBJECTIVE. The purpose of this report is to assess the findings on Esophagography in patients with esophageal stents for palliation of malignant tumors involving the esophagus.CONCLUSION. Radiologists should be familiar with findings of little importance (stent narrowing, flow of contrast medium around stent, stent kinks, and apparent esophageal narrowing below stent because of incompletely distended hiatal hernias) versus more important findings (polypoid defects above or below stent, narrowing within or below stent, delayed stent emptying, esophageal-airway fistulas, stent migration, and abutting of distal stent against greater curvature of stomach) on Esophagography after stent placement to guide endoscopists regarding the need for stent revision.
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Diseases of the esophagus: diagnosis with Esophagography.
Radiology, 2005Co-Authors: Marc S. Levine, Stephen E. RubesinAbstract:The barium esophagram is a valuable diagnostic test for evaluating structural and functional abnormalities of the esophagus. The study is usually performed as a multiphasic examination that includes upright double-contrast views with a high-density barium suspension, prone single-contrast views with a low-density barium suspension, and, not infrequently, mucosal-relief views with either density of barium suspension. The double-contrast phase optimizes the ability to detect inflammatory or neoplastic diseases, whereas the single-contrast phase optimizes the ability to detect hiatal hernias and lower esophageal rings or strictures. Fluoroscopic examination of the esophagus is also important for assessing motility disorders such as achalasia and diffuse esophageal spasm. This article is a review of gastroesophageal reflux disease, other types of esophagitis, benign and malignant esophageal tumors, varices, lower esophageal rings, diverticula, and esophageal motility disorders, all of which can be diagnosed with the aid of Esophagography.
Kadek Deddy Ariyanta - One of the best experts on this subject based on the ideXlab platform.
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Tracheoesophageal Fistula Newborn Presentation and Outcome: Case Series
American Journal of Pediatrics, 2020Co-Authors: Putu Tarita Susanti, I Made Kardana, Kadek Deddy AriyantaAbstract:Tracheoesophageal fistula (TEF/TOF) represents one of the most rare congenital anomaly in pediatric centers. Its an abnormal connection (fistula) between esophagus and trachea, characterized by copious salivation associated with choking, coughing, vomiting, cyanosis coincident with the onset of feeding and aspiration. Tracheoesophageal fistula commonly associated with other congenital anomaly, particularly cardiac defects. Diagnose can be established early during antenatal care by ultrasonography and postnatal by babygram and Esophagography. Definitive management of TEF is surgical procedure. In this study we want to present outcome of our patients with tracheoesophageal fistula. Three cases were identified as tracheoesophageal fistula type C. The first and second case suffered vomit after feeding, then underwent Esophagography examination and got surgical procedure. The third case showed difficult entry of feeding tube and hypersalivation but did not get other supporting examinations due to worsening condition. The first case with stable condition and discharge from hospital, meanwhile the second and third case passed away due to severe comorbid. Tracheoesophageal fistula diagnosis should be done immediately for planning surgery procedure. Supportive management would be needed if there are comorbid diseases. The prognosis of TEF is determined by clinical improvement after surgery and comorbid disease.
Hyung Kim - One of the best experts on this subject based on the ideXlab platform.
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Esophageal varices in patients with cirrhosis: multidetector CT Esophagography--comparison with endoscopy.
Radiology, 2007Co-Authors: Hyung Kim, Yoon Jun Kim, Jeong Min Lee, Kee Don Choi, Young Jin Chung, Joon Koo Han, Jae Young Lee, Min Woo Lee, Chang Jin Han, Joon-il ChoiAbstract:Purpose: To evaluate the use of multidetector computed tomographic (CT) Esophagography to grade esophageal varices and differentiate between varices at low risk and those at high risk for bleeding, with endoscopy as the reference standard. Materials and Methods: This study was approved by the institutional review board; all subjects gave informed consent. Ninety patients with cirrhosis (65 men, 25 women; mean age, 54.8 years; range, 21–77 years) were prospectively enrolled and underwent endoscopy and CT Esophagography. Esophageal varices were graded independently at endoscopy by two endoscopists. CT esophagograms were interpreted retrospectively with a four-point scale by two radiologists blinded to other findings. Interobserver agreement between each radiologist and endoscopist was determined; endoscopic and CT esophagographic grades of esophageal varices were correlated. Radiologist performance for differentiation between low- and high-risk varices for bleeding on the basis of morphology at endoscopy wa...
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Three-dimensional MDCT imaging and CT Esophagography for evaluation of esophageal tumors: preliminary study
European radiology, 2006Co-Authors: Hyung Kim, Jeong Min Lee, Joon Koo Han, Jae Young Lee, Younghwan Kim, Hyun Ju Lee, Kyung-sook Shin, Byung Ihn ChoiAbstract:The aim of this study was to determine whether multidetector computed tomography (MDCT) imaging, including CT Esophagography (CTE), can be used as a comprehensive imaging test for esophageal tumors. Twenty-three patients with esophageal neoplasms underwent MDCT with esophageal distension and endoscopy. Of them, 20 underwent barium study. Two radiologists independently reviewed MDCT images with 3D CT Esophagography (CTE) including CT endoscopy and were asked to determine the presence of the esophageal lesions and characterize them using a five-point confidence scale. The radiologists’ performance for the lesion detection and characterization was evaluated by receiver operating characteristic (ROC) analysis. They were also requested to determine the local staging of esophageal cancer, and the overall accuracies of MDCT for local staging were calculated. The ability of MDCT with CTE was also evaluated compared with conventional studies. CTE images successfully revealed 14 of 16 esophageal cancers and all seven submucosal tumors. Two esophageal cancers, both confined to the mucosal layer, were undetected. The Az values of the MDCT images were 0.954–0.957 for determining the presence of a lesion and 0.954–0.995 for differentiating between cancer and submucosal tumors. The overall accuracies for T and N staging were 42.9% and 85.7%, respectively. In 80% and 74% of cases, CTE gave similar or superior information to barium study and endoscopy, respectively. MDCT Esophagography has the potential to serve as a comprehensive imaging modality for evaluating esophageal tumors as it provides accurate information regarding the detection and characterization of esophageal tumors as well as the similar information to conventional studies.