Learning objectives
The purpose of this exhibit is:
To describe the Time Barium Esophagogram (TBE) technique
Get acquainted with the proper way to perform the measurements of the height and width of the barium column
To learn how to avoid inadequate measurements in difficult scenarios (barium foam interface)
To show key points in the interpretation of images for correlation with clinical response to treatment
Background
Introduction:
Achalasia is a primary neurological esophageal motor disorder,
characterized by the absence of primary peristalsis and incomplete or absent relaxation of lower esophageal sphincter (LES) with swallowing,
and normal or abnormal high resistance LES pressure.
It is the most common esophageal motor disorder,
with mean incidences of 0.3-1.63 per 100 000 people per year in adults,
it occurs with equal distribution in men and women with a bimodal distribution,
early onset at age 20 to 40,
and late onset after age 60.
The clinical...
Findings and procedure details
How to interpret data:
The esophagus emptying is assessed over time (Fig. 8) with the heights and widths of the barium column.
The barium height (Fig. 9a) is the distance from the distal esophagus (identified by the bird´s beak appearance at the level of LES) to the top of the barium column (at the level at which the barium-foam interface is best defined),
and barium width (Fig. 9b) is the maximum diameter of the barium column,
measured perpendicular to the approximated long axis at its...
Conclusion
Time barium esophagogram evaluates the effectiveness of treatment for achalasia better than does an evaluation of the symptoms themselves.
This technique is also simple to do and interpret,
and should be used in patients with achalasia and to follow-up those who have been treated.
References
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Achalasia: A review of clinical diagnosis,
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Woodfield CA,
Levine MS,
Rubesin SE,
Langlotz CP,
Laufer I.
Diagnosis of Primary Versus Secondary Achalasia: Radiology.
2000;(September):727-731.
Torresan F,
Ioannou A,
Azzaroli F,
Bazzoli F.
Annals of Gastroenterology ,
Volume 28 ,
No 3 ( 2015 ) Treatment of achalasia in the era of high resolution manometry.
2019;28(3):2015-2020.
Levine MS,
Rubesin SE.
Diseases of the esophagus: diagnosis with esophagography.
Radiology.
2005;237(2):414-427.
doi:10.1148/radiol.2372050199....