Follow-up barium study after a negative water-soluble contrast examination for suspected esophageal leak: is it necessary?

Thomas Ray Sanchez, Grant S. Holz, Michael T Corwin, Robert J. Wood, Sandra L. Wootton-Gorges

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

The purpose of this study was to determine the value of follow-up barium esophogram in diagnosing esophageal injury or leak if the initial water-soluble contrast examination of the esophagus is normal. An institutional review board (IRB)-approved retrospective review of all pediatric patients less than 18 years old referred to the radiology department for evaluation of esophageal injury or leak was performed for a 9-year period from 2005 to 2014. The majority of patients had unexplained pneumomediastinum, chest trauma (gunshot or puncture wound), or foreign body ingestion as the reason for the referral. Forty-nine patients (age range 10 days to 17 years) underwent an initial water-soluble esophogram immediately followed by a barium esophogram. Forty-six studies were negative on both water-soluble contrast and barium studies. Two studies were both positive on the initial water-soluble contrast and subsequent barium studies. A single study showed the esophageal leak only in the water-soluble study, with the follow-up barium exam being normal. The result of this study indicates that a single-contrast water-soluble esophogram alone is sensitive in the diagnosis of esophageal injury or leak. It has a 100 % sensitivity and negative predictive value. A follow-up barium esophogram only increases the study time and radiation dose to the patient.

Original languageEnglish (US)
Pages (from-to)539-542
Number of pages4
JournalEmergency Radiology
Volume22
Issue number5
DOIs
StatePublished - Jun 16 2015

Fingerprint

Barium
Water
Wounds and Injuries
Mediastinal Emphysema
Research Ethics Committees
Foreign Bodies
Punctures
Radiology
Esophagus
Thorax
Referral and Consultation
Eating
Radiation
Pediatrics

Keywords

  • Barium
  • Esophageal injury
  • Esophageal leak
  • Esophogram
  • Water-soluble contrast

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Emergency Medicine

Cite this

Follow-up barium study after a negative water-soluble contrast examination for suspected esophageal leak : is it necessary? / Sanchez, Thomas Ray; Holz, Grant S.; Corwin, Michael T; Wood, Robert J.; Wootton-Gorges, Sandra L.

In: Emergency Radiology, Vol. 22, No. 5, 16.06.2015, p. 539-542.

Research output: Contribution to journalArticle

@article{71eabd4be29644baaa5e937d36431152,
title = "Follow-up barium study after a negative water-soluble contrast examination for suspected esophageal leak: is it necessary?",
abstract = "The purpose of this study was to determine the value of follow-up barium esophogram in diagnosing esophageal injury or leak if the initial water-soluble contrast examination of the esophagus is normal. An institutional review board (IRB)-approved retrospective review of all pediatric patients less than 18 years old referred to the radiology department for evaluation of esophageal injury or leak was performed for a 9-year period from 2005 to 2014. The majority of patients had unexplained pneumomediastinum, chest trauma (gunshot or puncture wound), or foreign body ingestion as the reason for the referral. Forty-nine patients (age range 10 days to 17 years) underwent an initial water-soluble esophogram immediately followed by a barium esophogram. Forty-six studies were negative on both water-soluble contrast and barium studies. Two studies were both positive on the initial water-soluble contrast and subsequent barium studies. A single study showed the esophageal leak only in the water-soluble study, with the follow-up barium exam being normal. The result of this study indicates that a single-contrast water-soluble esophogram alone is sensitive in the diagnosis of esophageal injury or leak. It has a 100 {\%} sensitivity and negative predictive value. A follow-up barium esophogram only increases the study time and radiation dose to the patient.",
keywords = "Barium, Esophageal injury, Esophageal leak, Esophogram, Water-soluble contrast",
author = "Sanchez, {Thomas Ray} and Holz, {Grant S.} and Corwin, {Michael T} and Wood, {Robert J.} and Wootton-Gorges, {Sandra L.}",
year = "2015",
month = "6",
day = "16",
doi = "10.1007/s10140-015-1329-2",
language = "English (US)",
volume = "22",
pages = "539--542",
journal = "Emergency Radiology",
issn = "1070-3004",
publisher = "Springer New York",
number = "5",

}

TY - JOUR

T1 - Follow-up barium study after a negative water-soluble contrast examination for suspected esophageal leak

T2 - is it necessary?

AU - Sanchez, Thomas Ray

AU - Holz, Grant S.

AU - Corwin, Michael T

AU - Wood, Robert J.

AU - Wootton-Gorges, Sandra L.

PY - 2015/6/16

Y1 - 2015/6/16

N2 - The purpose of this study was to determine the value of follow-up barium esophogram in diagnosing esophageal injury or leak if the initial water-soluble contrast examination of the esophagus is normal. An institutional review board (IRB)-approved retrospective review of all pediatric patients less than 18 years old referred to the radiology department for evaluation of esophageal injury or leak was performed for a 9-year period from 2005 to 2014. The majority of patients had unexplained pneumomediastinum, chest trauma (gunshot or puncture wound), or foreign body ingestion as the reason for the referral. Forty-nine patients (age range 10 days to 17 years) underwent an initial water-soluble esophogram immediately followed by a barium esophogram. Forty-six studies were negative on both water-soluble contrast and barium studies. Two studies were both positive on the initial water-soluble contrast and subsequent barium studies. A single study showed the esophageal leak only in the water-soluble study, with the follow-up barium exam being normal. The result of this study indicates that a single-contrast water-soluble esophogram alone is sensitive in the diagnosis of esophageal injury or leak. It has a 100 % sensitivity and negative predictive value. A follow-up barium esophogram only increases the study time and radiation dose to the patient.

AB - The purpose of this study was to determine the value of follow-up barium esophogram in diagnosing esophageal injury or leak if the initial water-soluble contrast examination of the esophagus is normal. An institutional review board (IRB)-approved retrospective review of all pediatric patients less than 18 years old referred to the radiology department for evaluation of esophageal injury or leak was performed for a 9-year period from 2005 to 2014. The majority of patients had unexplained pneumomediastinum, chest trauma (gunshot or puncture wound), or foreign body ingestion as the reason for the referral. Forty-nine patients (age range 10 days to 17 years) underwent an initial water-soluble esophogram immediately followed by a barium esophogram. Forty-six studies were negative on both water-soluble contrast and barium studies. Two studies were both positive on the initial water-soluble contrast and subsequent barium studies. A single study showed the esophageal leak only in the water-soluble study, with the follow-up barium exam being normal. The result of this study indicates that a single-contrast water-soluble esophogram alone is sensitive in the diagnosis of esophageal injury or leak. It has a 100 % sensitivity and negative predictive value. A follow-up barium esophogram only increases the study time and radiation dose to the patient.

KW - Barium

KW - Esophageal injury

KW - Esophageal leak

KW - Esophogram

KW - Water-soluble contrast

UR - http://www.scopus.com/inward/record.url?scp=84942500698&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84942500698&partnerID=8YFLogxK

U2 - 10.1007/s10140-015-1329-2

DO - 10.1007/s10140-015-1329-2

M3 - Article

C2 - 26076944

AN - SCOPUS:84942500698

VL - 22

SP - 539

EP - 542

JO - Emergency Radiology

JF - Emergency Radiology

SN - 1070-3004

IS - 5

ER -