Esophagography - Causes, symptoms and treatment. MF.

Esophagography is one of the methods for diagnosing diseases of the esophagus with the help of X-rays. Due to the fact that the tissues of the esophagus are completely transmitted, without delaying X-ray radiation, this method is based on the ingestion of an x-ray contrast material - barium sulfate suspension.

Barium suspension when ingested into the esophagus tightly envelops its walls, allowing you to see on the screen the smallest defects and shadows in the lumen of the organ. In addition, with a consecutive rapid acquisition of several shots in a row receive information about the state of esophageal motility, which is especially important in gastroesophageal reflux.

The method is administered with a wide range of complaints from the digestive system, and due to inexpensive equipment and technical uniqueness of the technique is widespread. Radiography of the esophagus can be prescribed repeatedly and is absolutely safe, since the dose of radiation obtained during the examination is significantly lower than that which can harm the health.

Indications.

Esophagography may be prescribed as an adjunct to esophagoscopy or to EGF, or as an independent diagnostic method. Indications for X-ray of the esophagus are suspected diseases such as:

- foreign bodies of the esophagus,
- gastroesophageal reflux,
- congenital anomalies of the esophagus in infants,
- diaphragmatic hernia,
- swelling, stricture( spike), diverticulum, esophagus polyp,
- violations of the motor function of the esophagus of various nature( primary and secondary disorders of esophageal motility).

Contraindications.

The study is contraindicated in pregnancy, especially in the early stages, as well as in patients with acute surgical pathology - intestinal obstruction, acute appendicitis, pancreatitis and other diseases requiring urgent surgical intervention. In addition, it is not recommended to perform the study with acute myocardial infarction, pulmonary edema, severe respiratory failure and other urgent conditions.

Preparation for the study.

On the eve of esophagography, a patient should follow an easy diet for two to three days. Do not eat fatty, fried and spicy dishes, as irritants can affect the esophageal motility. Also, you should cancel your medications( omez, famotidine, nitrates, nifedipine, etc.) 24 hours before the test, as recommended by your doctor.

In the evening before the examination, a light dinner is possible, and on the day of the study it is not allowed to drink even water. A baby in the morning is also not fed, as the procedure should be performed on an empty stomach. If esophagography is carried out urgently, for example, if a suspected foreign body of the esophagus is suspected, compliance with these rules is allowed.

Carrying out the research.

Esophagography can be performed in a clinic in a planned order or in a hospital, where the patient is delivered to emergency indications. After the patient is explained what the research features are, he signs an informed voluntary consent to the procedure, he is asked to remove dentures, jewelry and other metal objects that can cause a shadow in the pictures. Then the patient goes to the X-ray room, faces up to the screen, and the first survey of the chest is made. After that, he is invited to drink an aqueous solution of barium of a thick consistency and with a slight calcareous aftertaste.

Immediately the first picture is taken. If the examination is conducted in connection with the suspicion of a foreign body, one or two pictures are sufficient. If it is necessary to identify abnormalities of esophageal motility, a series of shots is performed in the mode of X-ray film during the first two seconds after the throat of barium - it is during this time that normally the liquid enters the stomach through the esophagus.

Then the patient again takes a sip of barium with subsequent imaging in a straight, lateral and oblique projections, if necessary, targeted images are taken. After another sip, the patient's suspension is laid on a table with a raised butt-end. This is necessary to assess the consistency of the lower esophageal sphincter, if suspected reflux, and to identify hernia of the esophageal aperture of the diaphragm. After performing all the necessary shots, the patient is offered to wait for the doctor's report or escorted to the department from which he was sent.

The entire procedure takes 10-15 minutes, without causing the slightest unpleasant sensations in the subject. After the examination, the patient can return home if it was planned, and there were no conditions requiring emergency care.

For two or three days a white stool is visible in the patient, caused by the removal of barium from the body. At this time, there may be a slight swelling of the abdomen, moderate pain in the abdomen. If barium has not been removed from the body for three days, and unpleasant symptoms and pain bring severe discomfort, you should notify the attending physician, since a dense barium suspension in the intestine can lead to constipation. To prevent this, the patient should consume more liquid after the procedure of esophagography.

Decoding of the results of esophagography.

Normally a barium suspension, swallowed when tested in one sip, reaches the stomach after two seconds. Contours of the mucosa of the esophagus, contrasted with barium, even, without defects and additional shadows. Their appearance may indicate a tumor, diverticulum or ulcer on the mucosa, and if the patient has motor disorders, the suspension lingers in the esophagus longer.

Normal radiographic picture when contrasting the esophagus.

Complications.

Esophagography is a safe procedure, and complications do not arise. In rare cases, aspiration( inhalation) of barium suspension in patients with a violation of the act of swallowing and breathing is possible.

Doctor therapist Sazykina O.Yu.