A pictorial essay on radiography of swallowing and esophageal disorders

Abstract

Numerous abnormalities, both of congenital and acquired causes, can compromise the swallowing process and the ability of the esophagus to transmit the food from the mouth to the stomach in pediatric population. Patients often present a history of aspiration, dysphagia or feeding difficulties. The imaging evaluation typically begins with a fluoroscopic examination of the swallowing process and esophagus (esophagram), using either barium or water soluble contrast medium. This pictorial essay delineates the imaging features of normal anatomy and physiology of the swallowing and the esophagus, as well as the imaging features of common pediatric swallowing dysfunctions and various esophageal abnormalities. It is designed in order to assist radiologists in providing an appropriate diagnosis when confronted with a suspected disease in this anatomic region, and when appropriate, what additional testing to recommend. It is also designed to inform pediatricians about the wealth of diagnostic information that may be collected when performing an esophagram; a relatively simple radiographic examination.

Conclusion - Radiographic imaging of swallowing and the esophagus remains the primary imaging modality in patients with a history of aspiration, dysphagia and feeding problems. It offers valuable diagnostic information related to anatomy, morphology and peristalsis.