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Evaluation of Dysphagia: Esophagoscopy vs. X-ray

M. FARIVAR, and J. L. PERROTTO, GASTROINTESTINAL Units, NORWOOD HOSPITAL, NORWOOD, MA, and STURDY MEMORIAL HOSPITAL, ATTLEBORO, MA

We have done a prospective study on patients with dysphagia to solids to determine the efficacy of radiographic studies versus esophagoscopy. Eighty-one consecutive patients in two community hospitals, referred for evaluation of dysphagia were studied initially, with barium swallow or cine-esophagogram, or both. All patients were then esophagoscoped with a flexible fiberoptic esophagogastroduodenoscope.

It was found: 1) Radiographic studies produced false negative results in 42% of the cases. 2) Radiographic studies did not reveal esophageal carcinomas in six of ten patients. 3) Flexible esophagoscopy identified the cause of dysphagia in 100% of the patients. 4) The etiologies of dysphagia as determined by esophagoscopy were: benign esophageal stricture - 77%; esophageal malignancy - 12%; webs and rings - 11%. S. Endoscopic biopsies conformed a diagnosis of benign or malignant disease in all but one patient who had gastric lymphoma metastatic to the esophagus. These studies indicate that all patients who have dysphagia to solids should have esophagoscopy with biopsy.

 

 

 

 

 

         This is an educational site created by M. Farivar, M.D. The information provided is the author's opinion based on years of clinical experience and research.  You are advised to consult your own physician about the applicability of this information to your particular needs.  Also, keep in mind that symptom response to therapy does not preclude the presence of more serious conditions. 

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