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

3 Scopus citations

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

Keywords

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

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Emergency Medicine

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