A young patient presents with history of dysphagia more to liquids than solids. The first investigation is
Despite widespread application of endoscopy, barium studies still remain the primary imaging technique in suspected esophageal disorders, especially in cases of dysphagia. Barium studies are simple to perform, inexpensive and highly sensitive. Endoscopy will often be required after a barium swallow, especially for biopsy purposes. It is helpful that barium studies precede endoscopy. This paicularly applies to high dysphagia when an unsuspected pharyngeal pouch can be readily entered and perforated with scope. Also esophagoscopy is less good at identifying motility disorders. Endoscopic USG(EUS) only overcomes limitation of CT in assessing esophagus and is IOC for local staging of esophageal cancer. It is also sensitive in detecting small GIST. Role of CT in esophageal disease is mainly confined to cancer staging, especially in advanced cases and in suspected esophageal perforation.
Barium swallow
Esophagoscopy
EUS
CT scan
Gastrointestinal Radiology