Findings Single-contrast esophagram.

A moderate-sized hiatal hernia is present with esophageal shortening and narrowing beginning at the gastroesophageal junction. The margins of the stricture taper gradually.

Diagnosis Chronic reflux esophagitis: focal stricture

Findings Single-contrast esophagram. A long distal esophageal stricture, with an associated hiatal hernia, is present.

Diagnosis Chronic reflux esophagitis: long stricture

Single-contrast esophagram, A short stricture is present in

the mid esophagus, with some luminal irregularity at the level of the stricture. A short esophagus ... type hiatalhernia also is visible.

Di a.gno sis
Barrett esophagus stricture

Findings Single-contrastesophagram. Dilatation of the esophagus with a beaklike deformity near the gastroesophageal junction. Aperistalsis of the smooth muscle portion (distal two-thirds) was observed.

A. Single-contrast esophagram. Fixed, smooth narrowing is present in distal esophagus. Proximal esophagus is dilated. At fluoroscopy, narrowing remained unchanged, even after esophagus was half filled with contrast material.

B. Abdominal CT with oral contrast. A soft tissue mass (arrows) causing gastric wall thickening is present at the level of the gastroesophageal junction. The mass extends into the distal esophagus.

Diagnosis 'Carcinoma ofthe gastroesophageal junction (pseudoachalasia)

Single-contrast csophagram. There is a long,narrow stricture involving the mid and distal esophagus.

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Caustic (lye-induced) stricture

Frontal (A) and lateral (B) images show persistent multifocal strictures in the cervical and 'upper thoracic esophagus.

Single~contrast esophagram.

Diagnosis ·h'· •...•. ,. ('b ,. , icatricia pcmphigoi '"d· strictures (benign mucous C'· ,...al·

membrane pemphigoid)

Double-contrast esophagram .. A.lo.n.g, smooth stricture is present in the mid esophagus,

re

A .. Single~,contrast esophagram.. Extrinsic compression , and narrowing involve the mid esophagus,

B.. Contrast ... , enhanced 'CT~ Bulky mediastinal and hilar lymphadenopathy is present.

Dlagnosls Extrinsic esophageal compression by lymphomatous mediastinal adenopathy
iO II

Case 1.61. Single-contrast esophagram. There is dilatation of the esophagus with a small esophageal hiatal hernia. Real-time imaging showed. absent peristalsis in the distal two-thirds of the esophagus and free gastroesophageal reflux of barium in the recumbent position. Slight irregularity is present at the gastroesophageal junction.

Case 1.62. Unenhanced high-resolution CT. Peripheral interstitial fibrotic changes are present in the lung bases with associated ground-glass infiltrates and traction bronchiectasis. Pulmonary findings are consistent with nonspecific interstitial pneumonitis. Dilatation of the distal esophagus also can be seen with an air-fluid level.

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