Type:
Educational Exhibit
Keywords:
Not applicable, Multidisciplinary cancer care, Cancer, Diagnostic procedure, Barium meal, Audit and standards, Fluoroscopy, CT, Stomach (incl. Oesophagus), Oncology, Gastrointestinal tract, GI Tract
Authors:
J. D. Yeomans, E. I. R. Parks, E. Boggon, J. Fleming, M. Booth, R. Ellis Owen; CARDIFF/UK
DOI:
10.26044/ecr2020/C-08034
Background
Prompt investigation with oesophago-gastroduodenoscopy (OGD) and tissue biopsy are vital for the rapid diagnosis and treatment of upper GI cancer.1
In the UK, NICE guidelines recommend OGD as the gold standard investigation.2
Barium imaging is suggested as a suitable substitute when OGD is refused or fails according to Royal College of Radiology (RCR) iRefer guidelines.3 However, barium imaging does not exclude malignancy and positive findings require further evaluation by OGD or alternative modalities.1
This audit aims to assess the role of barium imaging in the investigation of upper GI cancer at a tertiary referral centre.
Fig. 1: Barium swallow demonstrating the three key features of oesophageal carcinoma: 1. An irregular stricture 2. Pre-stricture dilatation with 'hold-up' 3. Shouldering of the stricture
(Reference 4)
References: Department of Radiology, University Hospital of Wales, Cardiff 2019
Fig. 2: Oesophageal carcinoma as seen via OGD. Endoscopy allows for biopsy sampling at the same time.
References: Samir [CC-BY-SA-3.0] via Wikimedia Commons