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Gastroenterology
Published in Kaji Sritharan, Jonathan Rohrer, Alexandra C Rankin, Sachi Sivananthan, Essential Notes for Medical and Surgical Finals, 2021
Kaji Sritharan, Jonathan Rohrer, Alexandra C Rankin, Sachi Sivananthan
Diverticulum of the pharyngeal muscosa through a weakness in the wall between the thryopharyngeus and cricopharyngeus. Presentation: typically with abnormal fetor and dysphagia or complications such as aspiration. Diagnosis is confirmed with barium swallow. Management: pouch can be excised surgically if problematic.
Paper 1
Published in Amanda Rabone, Benedict Thomson, Nicky Dineen, Vincent Helyar, Aidan Shaw, The Final FRCR, 2020
Amanda Rabone, Benedict Thomson, Nicky Dineen, Vincent Helyar, Aidan Shaw
A 36 year old female patient originally presented to her GP with difficulty swallowing solids and liquids, associated chest discomfort and occasional episodes of regurgitation. Barium swallow helps to obtain the diagnosis. There is smooth distal oesophageal tapering with proximal oesophageal dilatation and tertiary contractions. This is successfully treated at the time but 19 years later the same patient presents with dysphagia again. The barium swallow now demonstrates an irregular, shouldered narrowing with proximal oesophageal dilatation. Endoscopy confirms malignancy.
Applications in radiology
Published in Sam Beddar, Luc Beaulieu, Scintillation Dosimetry, 2018
Daniel E. Hyer, Ryan F. Fisher, Maxime Guillemette
Gastrointestinal (GI) exams: GI procedures involve diagnosing diseases of the GI system and involve the patient swallowing a barium contrast agent. A barium swallow exam, as seen in Figure 11.5, involves capturing high-frame-rate images of the patient swallowing a contrast agent in order to assess and diagnose potential issues with the oral cavity, pharynx, and esophagus. An upper GI series, as shown in Figure 11.6, is similar but focuses on the esophagus, stomach, and duodenum to assess their functionality.
Effect of COVID-19 on the incidence of postintubation laryngeal lesions
Published in Baylor University Medical Center Proceedings, 2023
Madison Buras, Nicole DeSisto, Randall Holdgraf
The modified barium swallow study and FEES are the most common modalities for diagnosing oropharyngeal swallowing dysfunction.8 However, we chose FEES as the diagnostic modality in our study for a few reasons. First, the modified barium swallow study, which uses radiography and barium, is typically performed in the radiology suite. FEES, though, uses nasal endoscopy, a procedure that can be performed at the bedside and is, therefore, more pertinent for ICU-level patients and those who are COVID-positive at the time of examination, prohibiting transport. Second, although both modalities assess the oral and pharyngeal phases of swallowing, FEES is also capable of providing a direct view of the pertinent anatomy and physiology. Because of this ability to gain a clear view of relevant anatomy, recent guidelines suggest FEES is a better diagnostic modality for dysphagia in patients after oral endotracheal intubation.8 Third, FEES has also consistently demonstrated worse scores in studies in which the same bolus and same swallow were compared, suggesting that FEES may be a more sensitive diagnostic modality.9
Update on the diagnosis and management of pediatric laryngotracheal stenosis
Published in Expert Review of Respiratory Medicine, 2022
Matthew M Smith, Lauren S Buck
Another evaluation of swallowing is the modified barium swallow study or video swallow study. This is a useful adjunct for evaluating swallowing, but does not allow the clinician to document vocal fold mobility. If patients are unable to ingest barium (ie they do not take a significant amount of food by mouth at baseline), then the barium swallow examination will not provide meaningful results. This is in contrast to the FEES exam which can dye the patient’s saliva and allow the physician to evaluate if they are tolerating their own secretions. Another tool to use for the evaluation of aspiration in tracheostomy patients is placing a small amount of green food coloring in the patient’s saliva or food and seeing if green contents are expectorated or suctioned from the tracheostomy site.
Diagnosis and management of laryngotracheal stenosis
Published in Expert Review of Respiratory Medicine, 2018
Matthew M Smith, Robin T Cotton
Another evaluation of swallowing is the modified barium swallow study or video swallow study. Patients ingest different consistencies of barium while continuous radiographs of the upper airway and esophagus are obtained. This is a useful adjunct for evaluating swallowing, but does not allow the clinician to document vocal fold mobility. If patients are unable to ingest barium (ie they do not take a significant amount of food by mouth at baseline), then the barium swallow examination will not provide meaningful results because of the lack of barium swallowed. This is in contrast to the FEES exam which can dye the patient’s saliva and allow the physician to evaluate if they are tolerating their own secretions. Another tool to use for the evaluation of aspiration in tracheostomy patients, is placing a small amount of green food coloring in the patient’s saliva or food and seeing if green contents are expectorated or suctioned from the tracheostomy site.