Morphology of the esophagus

Abstract

Barium esophagography is an invaluable radiologic technique for detecting a host of morphologic abnormalities in the esophagus. Double-contrast barium studies are particularly well suited for diagnosing reflux esophagitis and its complications, including peptic strictures and Barrett’s esophagus. Double-contrast esophagography is also useful for detecting infectious esophagitis and for differentiating the underlying causes, including Candida albicans, the herpes simplex virus, cytomegalovirus, and human immunodeficiency virus. Barium studies can also facilitate the diagnosis of drug-induced esophagitis, eosinophilic esophagitis, and other less common forms of esophagitis. In patients with dysphagia, barium esophagography is a sensitive test for detecting the two common malignant tumors of the esophagus—squamous cell carcinoma and adenocarcinoma. Finally, esophagography can be used to diagnose other morphologic abnormalities in the esophagus, including webs, rings, diverticula, varices, foreign body impactions, fistulas, and perforation. All of these conditions are discussed in this chapter.