1. Esophageal Conditions: A
Radiological Perspective
This comprehensive list outlines the radiological findings associated with
various esophageal conditions, as observed through barium
esophagograms. From mild esophagitis to complex structural
abnormalities, these diagnostic insights can aid clinicians in accurately
identifying and managing a wide range of esophageal disorders.
Na by Nagasai Pelala
2. Inflammatory Conditions
Mild Esophagitis
Characterized by fold
thickening, this condition
represents the mildest form
of esophageal
inflammation. The barium
esophagogram may reveal
subtle changes in the
esophageal mucosal
pattern, indicating the
presence of this condition.
Moderate Esophagitis
Superficial erosions,
appearing as lines and
punctate defects, are the
hallmark of moderate
esophagitis on the barium
esophagogram. These
findings indicate a more
advanced stage of
esophageal inflammation.
Severe Esophagitis
In severe esophagitis, the
barium esophagogram may
reveal a few short and fixed
transverse folds, reflecting
the more significant
mucosal damage and
scarring associated with
this condition.
3. Anatomical Variations
1 Feline Folds
(Physiologic)
These numerous, fine,
delicate, symmetric,
and transient folds are
a normal anatomical
variant and do not
indicate any
underlying pathology.
2 Chronic Reflux
Induced Strictures
Chronic
gastroesophageal
reflux can lead to the
development of short
segment strictures
above the
gastroesophageal
junction, often
accompanied by a
short type esophageal
hernia.
3 Intramural
Esophageal
Pseudodiverticulo
sis
Diffuse tiny
outpouchings, most
commonly due to
chronic reflux
esophagitis, can be
observed on the
barium
esophagogram.
4. Metaplastic and Neoplastic Conditions
Barrett's Esophagus
This condition is
characterized by a mid-
esophagus stricture, often
accompanied by a hiatal
hernia and possible
reticular changes, as seen
on the barium
esophagogram. These
findings are indicative of the
metaplastic changes
associated with Barrett's
esophagus.
Medication-Induced
Esophagitis
Certain medications can
cause esophageal irritation
and inflammation, leading
to the formation of strictures
at anatomical narrowings,
as observed on the barium
esophagogram.
Eosinophilic
Esophagitis
Luminal narrowing and
furrowing in the upper
esophagus are
characteristic radiological
findings associated with
eosinophilic esophagitis, a
condition driven by an
eosinophilic immune
response.
5. Infectious and Inflammatory
Conditions
Candidiasis
Multiple plaque-like filling defects on
the barium esophagogram are
indicative of esophageal candidiasis, a
fungal infection that can occur in
immunocompromised individuals.
Herpes Esophagitis
The barium esophagogram may reveal
multiple discrete ulcerations on an
otherwise normal esophageal mucosal
background, characteristic of herpes
esophagitis.
Cytomegalovirus (CMV) Infection
A large solitary discrete ulcer, especially in HIV-positive patients, is a typical radiological
finding associated with CMV esophagitis.
6. Motility Disorders
Achalasia
The barium esophagogram
in achalasia typically
shows a dilated
esophagus with a standing
column of contrast and a
beak-like stricture near the
gastroesophageal junction,
reflecting the impaired
esophageal motility and
incomplete relaxation of
the lower esophageal
sphincter.
Pseudoachalasia /
Carcinoma
In cases of
pseudoachalasia or
esophageal carcinoma, the
barium esophagogram
may reveal a fixed rigid
stricture with a soft tissue
mass evident on CT,
distinguishing it from the
classic achalasia findings.
Diffuse Esophageal
Spasm (DES)
The characteristic
corkscrew appearance on
the barium esophagogram
is a hallmark of diffuse
esophageal spasm, a
motility disorder
characterized by
uncoordinated, non-
peristaltic contractions of
the esophageal smooth
muscle.
7. Structural Abnormalities
Leiomyoma
A submucosal, circumscribed
mass with a smooth
impression on the
esophageal contour is
characteristic of an
esophageal leiomyoma, a
benign smooth muscle
tumor.
Esophageal Varices
Serpentine filling defects with
a scalloped contour in the
distal esophagus are
indicative of esophageal
varices, dilated veins that
can develop due to portal
hypertension.
Zenker's Diverticulum
A diverticulum in the
posterior wall of the cervical
esophagus, known as a
Zenker's diverticulum, can be
visualized on the barium
esophagogram.
8. Miscellaneous Conditions
Caustic Strictures Long segment narrowing with dysmotility,
irregular margins, edema, and plaques of
sloughing mucosa.
Glycogenic Acanthosis Nodular filling defect resembling reticular
changes.
Foreign Bodies Hard objects typically lodged in the upper
esophagus.
Meat Impaction Commonly found at the gastroesophageal
junction.
