Boerhaave syndrome diagnostic study of choice: Difference between revisions
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__NOTOC__ | __NOTOC__ | ||
{{Boerhaave syndrome}} | {{Boerhaave syndrome}} | ||
{{CMG}}; {{AE}} | {{CMG}}; {{AE}} {{Ajay}}, {{FT}} | ||
== Overview == | == Overview == | ||
Contrast | Contrast [[esophagogram]] usually establishes the diagnosis of an [[Boerhaave syndrome|esophageal perforation]], the location and extent of [[perforation]]. The accuracy of the test depends on the size and location of the [[perforation]] and the technique used for the study. [[Gastrografin]], a water-soluble [[contrast]] is used for the esophagogram [[procedure]]. If the [[Gastrografin]] [[esophagogram]] is inconclusive, a [[Barium chloride|barium esophagogram]] should be performed. [[Gastrografin]] is preferred over the [[Barium chloride|barium esophagogram]] to prevent barium induced inflammatory response in [[mediastinum]] and [[pleural space]], whereas [[barium]] esophagogram is very efficient in picking the small [[Perforation|perforations]]. | ||
== Diagnostic Study of Choice == | == Diagnostic Study of Choice == | ||
=== Study of choice: === | === Study of choice: === | ||
*Contrast Esophagram usually establishes the diagnosis of an [[esophageal perforation]]<ref name="pmid3753071">{{cite journal |vauthors=Bladergroen MR, Lowe JE, Postlethwait RW |title=Diagnosis and recommended management of esophageal perforation and rupture |journal=Ann. Thorac. Surg. |volume=42 |issue=3 |pages=235–9 |year=1986 |pmid=3753071 |doi= |url=}}</ref><ref name="pmid7089304">{{cite journal |vauthors=Dodds WJ, Stewart ET, Vlymen WJ |title=Appropriate contrast media for evaluation of esophageal disruption |journal=Radiology |volume=144 |issue=2 |pages=439–41 |year=1982 |pmid=7089304 |doi=10.1148/radiology.144.2.7089304 |url=}}</ref><ref name="pmid1126592">{{cite journal |vauthors=James AE, Montali RJ, Chaffee V, Strecker EP, Vessal K |title=Barium or gastrografin: which contrast media for diagnosis of esophageal tears? |journal=Gastroenterology |volume=68 |issue=5 Pt 1 |pages=1103–13 |year=1975 |pmid=1126592 |doi= |url=}}</ref><ref name="pmid1193339">{{cite journal |vauthors=Schwartz SS |title=Letter: Barium or gastrografin: which contrast media for diagnosis of esophageal tears? |journal=Gastroenterology |volume=69 |issue=6 |pages=1377 |year=1975 |pmid=1193339 |doi= |url=}}</ref><ref name="pmid1115308">{{cite journal |vauthors=Vessal K, Montali RJ, Larson SM, Chaffee V, James AE |title=Evaluation of barium and gastrografin as contrast media for the diagnosis of esophageal ruptures or perforations |journal=Am J Roentgenol Radium Ther Nucl Med |volume=123 |issue=2 |pages=307–19 |year=1975 |pmid=1115308 |doi= |url=}}</ref> | *Contrast Esophagram usually establishes the diagnosis of an [[esophageal perforation]]:<ref name="pmid3753071">{{cite journal |vauthors=Bladergroen MR, Lowe JE, Postlethwait RW |title=Diagnosis and recommended management of esophageal perforation and rupture |journal=Ann. Thorac. Surg. |volume=42 |issue=3 |pages=235–9 |year=1986 |pmid=3753071 |doi= |url=}}</ref><ref name="pmid7089304">{{cite journal |vauthors=Dodds WJ, Stewart ET, Vlymen WJ |title=Appropriate contrast media for evaluation of esophageal disruption |journal=Radiology |volume=144 |issue=2 |pages=439–41 |year=1982 |pmid=7089304 |doi=10.1148/radiology.144.2.7089304 |url=}}</ref><ref name="pmid1126592">{{cite journal |vauthors=James AE, Montali RJ, Chaffee V, Strecker EP, Vessal K |title=Barium or gastrografin: which contrast media for diagnosis of esophageal tears? |journal=Gastroenterology |volume=68 |issue=5 Pt 1 |pages=1103–13 |year=1975 |pmid=1126592 |doi= |url=}}</ref><ref name="pmid1193339">{{cite journal |vauthors=Schwartz SS |title=Letter: Barium or gastrografin: which contrast media for diagnosis of esophageal tears? |journal=Gastroenterology |volume=69 |issue=6 |pages=1377 |year=1975 |pmid=1193339 |doi= |url=}}</ref><ref name="pmid1115308">{{cite journal |vauthors=Vessal K, Montali RJ, Larson SM, Chaffee V, James AE |title=Evaluation of barium and gastrografin as contrast media for the diagnosis of esophageal ruptures or perforations |journal=Am J Roentgenol Radium Ther Nucl Med |volume=123 |issue=2 |pages=307–19 |year=1975 |pmid=1115308 |doi= |url=}}</ref> | ||
** | **The location and | ||
** | **Extent of [[perforation]] | ||
*The accuracy of the test depends on | *The accuracy of the test depends on: | ||
** | **The size and location of the [[perforation]] | ||
** | **The technique used for the study | ||
*[[Gastrografin]] is a water-soluble contrast | *[[Gastrografin]] is a water-soluble contrast used for the [[esophagogram]] procedure. | ||
*If the [[Gastrografin]] | *If the [[Gastrografin]] [[esophagogram]] is inconclusive, a [[barium]] [[esophagogram]] should be performed. | ||
*[[Gastrografin]] is preferred over the [[barium]] esophagram to prevent [[barium]] induced [[inflammatory]] response in [[mediastinum]] or [[Pleural space|pleural spaces]], whereas [[barium]] esophagram is very efficient in picking the small [[Perforation|perforations]]. | *[[Gastrografin]] is preferred over the [[barium]] [[esophagram]] to prevent [[barium]] induced [[inflammatory]] response in [[mediastinum]] or [[Pleural space|pleural spaces]], whereas [[barium]] [[esophagram]] is very efficient in picking the small [[Perforation|perforations]]. | ||
*[[Barium]] esophagram can detect | *[[Barium]] esophagram can detect | ||
**Sixty percent of [[cervical]] [[Perforation|perforations]] | **Sixty percent of [[cervical]] [[Perforation|perforations]] | ||
Latest revision as of 19:13, 17 February 2021
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Ajay Gade MD[2]], Feham Tariq, MD [3]
Overview
Contrast esophagogram usually establishes the diagnosis of an esophageal perforation, the location and extent of perforation. The accuracy of the test depends on the size and location of the perforation and the technique used for the study. Gastrografin, a water-soluble contrast is used for the esophagogram procedure. If the Gastrografin esophagogram is inconclusive, a barium esophagogram should be performed. Gastrografin is preferred over the barium esophagogram to prevent barium induced inflammatory response in mediastinum and pleural space, whereas barium esophagogram is very efficient in picking the small perforations.
Diagnostic Study of Choice
Study of choice:
- Contrast Esophagram usually establishes the diagnosis of an esophageal perforation:[1][2][3][4][5]
- The location and
- Extent of perforation
- The accuracy of the test depends on:
- The size and location of the perforation
- The technique used for the study
- Gastrografin is a water-soluble contrast used for the esophagogram procedure.
- If the Gastrografin esophagogram is inconclusive, a barium esophagogram should be performed.
- Gastrografin is preferred over the barium esophagram to prevent barium induced inflammatory response in mediastinum or pleural spaces, whereas barium esophagram is very efficient in picking the small perforations.
- Barium esophagram can detect
- Sixty percent of cervical perforations
- Ninety percent of intrathoracic perforations.
-
Gastrografin Esophagram: With the ingestion of Gastrografin, a right-sided oesophageal leak into the pleural space quickly occurs. The leak crosses over slightly into the left pleural space and extends a little into the retrocrural/retroperitoneal space as well.; Source- Radiopaedia
References
- ↑ Bladergroen MR, Lowe JE, Postlethwait RW (1986). "Diagnosis and recommended management of esophageal perforation and rupture". Ann. Thorac. Surg. 42 (3): 235–9. PMID 3753071.
- ↑ Dodds WJ, Stewart ET, Vlymen WJ (1982). "Appropriate contrast media for evaluation of esophageal disruption". Radiology. 144 (2): 439–41. doi:10.1148/radiology.144.2.7089304. PMID 7089304.
- ↑ James AE, Montali RJ, Chaffee V, Strecker EP, Vessal K (1975). "Barium or gastrografin: which contrast media for diagnosis of esophageal tears?". Gastroenterology. 68 (5 Pt 1): 1103–13. PMID 1126592.
- ↑ Schwartz SS (1975). "Letter: Barium or gastrografin: which contrast media for diagnosis of esophageal tears?". Gastroenterology. 69 (6): 1377. PMID 1193339.
- ↑ Vessal K, Montali RJ, Larson SM, Chaffee V, James AE (1975). "Evaluation of barium and gastrografin as contrast media for the diagnosis of esophageal ruptures or perforations". Am J Roentgenol Radium Ther Nucl Med. 123 (2): 307–19. PMID 1115308.