Esophageal stricture other imaging findings

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Mahda Alihashemi M.D. [2]

Overview

Barium esophagography is helpful in the diagnosis of esophageal stricture. Findings on a barium esophagogram suggestive of benign esophageal stricture include concentric narrowing, smoothly tapering and eccentric narrowing, abrupt, asymmetric in malignant causes.

Other Imaging Findings

Benign strictures can be distinguished from malignant strictures based on barium esophagography:[1][2]

  • Benign: Concentric narrowing, smoothly tapering
  • Malignant: Eccentric narrowing, abrupt, asymmetric

Barium esophagography is helpful in the diagnosis esophageal stricture. Findings on a barium esophagography suggestive of esophageal stricture include:

Barium swallowing finding
Gastroesophageal Reflux Disease
Esophageal carcinoma Irregular contour and shelflike proximal and distal margins
Scleroderma Tapered narrowing in long segment of the distal esophagus 
Nasogastric intubation Long segment of narrowing in the distal esophagus 
Radiation stricture Smooth, tapered segment of concentric narrowing 
Drug-induced stricture  Asymmetric focal narrowing in the upper thoracic esophagus
Esophageal sclerotherapy Long, irregular stricture in the distal esophagus 
Caustic ingestion Segmental or diffuse stricture

References

  1. Luedtke P, Levine MS, Rubesin SE, Weinstein DS, Laufer I (2003). "Radiologic diagnosis of benign esophageal strictures: a pattern approach". Radiographics. 23 (4): 897–909. doi:10.1148/rg.234025717. PMID 12853664.
  2. Mendelson AH, Small AJ, Agarwalla A, Scott FI, Kochman ML (2015). "Esophageal anastomotic strictures: outcomes of endoscopic dilation, risk of recurrence and refractory stenosis, and effect of foreign body removal". Clin. Gastroenterol. Hepatol. 13 (2): 263–271.e1. doi:10.1016/j.cgh.2014.07.010. PMC 4289652. PMID 25019695.

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