RADIO: ESOPHAGUS
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Questions and Answers

A 40-year-old female with a history of heartburn and regurgitation undergoes a barium swallow study. The radiologist notes significant reflux of contrast from the stomach into the esophagus. Which of the following radiologic findings is most commonly associated with this condition?

  • Corkscrew appearance of the esophagus
  • Bird-beak appearance at the gastroesophageal junction
  • Reflux of contrast into the esophagus with delayed esophageal clearance (correct)
  • Dilated esophagus with air-fluid levels
  • You are asked to create a diagnostic protocol for a patient suspected of having gastroesophageal reflux disease (GERD). The patient reports symptoms of chronic heartburn and regurgitation. Which combination of radiologic studies would you prioritize to confirm the diagnosis and assess the severity of GERD?

  • Start with a plain abdominal X-ray, followed by an MRI of the chest
  • Begin with a barium swallow study to visualize reflux, followed by a CT scan to assess complications (correct)
  • Perform an endoscopic ultrasound first, followed by a contrast-enhanced X-ray
  • Conduct an initial PET scan to evaluate metabolic activity, then follow up with a barium swallow study
  • A 30-year-old male with a history of alcohol consumption and smoking presents with severe heartburn, chest pain, and dysphagia. You suspect esophagitis. Based on radiologic assessment, which of the following findings would be most indicative of esophagitis?

  • Dilated esophagus with smooth, symmetric narrowing of the distal portion
  • Multiple serpiginous filling defects along the esophageal wall
  • Corkscrew pattern with alternating areas of narrowing and dilation
  • Irregular esophageal lining with evidence of mucosal ulcerations or erosions (correct)
  • A 45-year-old patient presents with progressive dysphagia and chest pain. Radiologic studies are performed. Which of the following findings on a barium swallow study is pathognomonic for achalasia?

    <p>Uniform esophageal dilation with a narrowed gastroesophageal junction resembling a bird-beak</p> Signup and view all the answers

    A 45-year-old male presents with intermittent chest pain and dysphagia exacerbated by stress. A barium swallow study reveals a corkscrew appearance in the distal esophagus. What is the underlying pathophysiological mechanism responsible for this radiologic finding in Diffuse Esophageal Spasm?

    <p>Uncoordinated, simultaneous contractions of the esophageal smooth muscle at multiple levels</p> Signup and view all the answers

    A 65-year-old male presents with dysphagia and a sensation of food sticking in the throat. A barium swallow study is performed, revealing a posterior outpouching just above the upper esophageal sphincter. Based on the imaging findings and anatomy, what is the most likely explanation for the formation of this diverticulum?

    <p>Herniation through Killian's dehiscence in the hypopharynx</p> Signup and view all the answers

    A 55-year-old male with a history of cirrhosis presents with hematemesis. A barium swallow is performed, showing multiple serpiginous filling defects in the lower esophagus. Which of the following radiologic features is most indicative of esophageal varices in this clinical context?

    <p>Multiple irregular filling defects caused by dilated submucosal veins</p> Signup and view all the answers

    A 50-year-old female presents with heartburn and regurgitation. A barium swallow study is performed, revealing a portion of the stomach herniating through the esophageal hiatus into the thorax. A follow-up CT scan shows widening of the esophageal hiatus and displacement of the gastroesophageal junction above the diaphragm. Based on these findings, which type of hiatal hernia is most likely present, and what is the key distinguishing radiologic feature that supports this diagnosis?

    <p>Sliding hernia; gastroesophageal junction and part of the stomach herniate above the diaphragm</p> Signup and view all the answers

    A 2-year-old child presents with choking and drooling after playing with a coin. A plain chest X-ray shows a round metallic foreign body lodged in the upper esophagus. Based on the radiographic appearance and the child's symptoms, what is the most appropriate next step in the radiologic evaluation or management?

    <p>Perform a lateral chest X-ray to confirm the location and orientation of the foreign body</p> Signup and view all the answers

    A 60-year-old male presents with severe chest pain, fever, and difficulty swallowing after undergoing an endoscopy. A plain radiograph shows pneumomediastinum and subcutaneous emphysema. What is the most appropriate next imaging step to confirm esophageal perforation and assess its extent?

    <p>Perform a CT scan with oral contrast to evaluate for extraluminal air and contrast leakage</p> Signup and view all the answers

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