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Related Experiment Videos

X-ray-negative dysphagia: is endoscopy necessary?

J A DiPalma, G C Prechter, C E Brady

    Journal of Clinical Gastroenterology
    |October 1, 1984
    PubMed
    Summary

    For patients with dysphagia and normal barium esophagrams, endoscopy rarely finds esophageal carcinoma. Barium studies are often sufficient to rule out esophageal cancer in these cases.

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    Area of Science:

    • Gastroenterology
    • Diagnostic Imaging
    • Oncology

    Background:

    • Dysphagia is a common symptom requiring investigation.
    • Barium studies and endoscopy are primary diagnostic tools for esophageal conditions.
    • The utility of endoscopy in diagnosing esophageal carcinoma with normal barium studies is debated.

    Purpose of the Study:

    • To evaluate the diagnostic yield of endoscopy for esophageal carcinoma in patients with dysphagia and normal initial barium esophagrams.

    Main Methods:

    • Retrospective review of 195 patients with x-ray-negative dysphagia from 1974-1982.
    • Analysis of endoscopic findings, excluding cases with hiatal hernia or mild esophagitis.
    • Comparison with 56 confirmed esophageal carcinoma cases from the same period.

    Main Results:

    • No esophageal carcinoma was detected via endoscopy in patients with normal barium studies.
    • Only eight patients (4%) showed endoscopic abnormalities not visible on prior x-rays after exclusions.
    • All 56 esophageal carcinoma cases presented with abnormal barium esophagrams.

    Conclusions:

    • Endoscopy is not essential for excluding esophageal carcinoma when barium esophagrams are normal.
    • Barium esophagrams appear to be a reliable initial diagnostic tool for dysphagia when esophageal cancer is suspected.
    • Further investigation with endoscopy may be reserved for specific clinical indications beyond initial barium study results.

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