Imaging

Esophageal Diverticula

Preliminary Diagnosis: Esophageal Diverticula

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

Single contrast barium esophogram.

II. Describe the advantages and disadvantages of this technique for diagnosing esophageal diverticula.

Advantages

  • Can accurately depict characteristic appearance of an esophageal diverticulum.

  • Air distension is not necessary (which can cause patient discomfort).

  • The examination is relatively inexpensive.

  • No significant complications typify this outpatient procedure.

  • Barium is a relatively inert compound, and minor aspiration events are typically uneventful.

  • Usually the only imaging study required.

Disadvantages

  • Unable to adequately assess mucosal detail in the assessment of esophagitis.

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

  • Relative contraindication in pregnancy.

  • Contraindicated in gastrointestinal perforation (water soluble contrast agents can be utilized).

IV. What alternative imaging techniques are available?

Double contrast barium esophogram.

V. Describe the advantages and disadvantages of the alternative techniques for diagnosing esophageal diverticula.

Advantages

  • The examination is relatively inexpensive.

  • No significant complications typify this outpatient procedure.

  • Allows assessment of the esophageal mucosa.

  • Barium is a relatively inert compound, and minor aspiration events are typically uneventful.

  • Usually the only imaging study required.

Disadvantages

  • Exposure to ionizing radiation.

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

  • Relative contraindication in pregnancy.

  • Contraindicated in gastrointestinal perforation (water soluble contrast agents can be utilized).

  • Contraindicated in patients with aspiration or asthma.

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