DETECTION OF OCCULT ESOPHAGEAL NARROWING WITH A BARIUM TABLET DURING CHEST RADIOGRAPHY

Dysphagia is a delayed symptom of esophageal constriction and often ap pears after the luminal diameter is reduced to less than 10 mm. Earlie r diagnosis of benign or malignant strictures while clinically silent would be desirable; hence we investigated the detectability of occult esophageal lesions with the aid of an ingested barium tablet during ro utine chest radiography. We prospectively examined 300 patients older than 40 years, who were referred for chest films because of indication s unrelated to the upper gastrointestinal tract. Each patient was inst ructed to swallow a 12.5-mm barium tablet with 100 mL of water immedia tely prior to the exposure of posteroanterior and lateral chest films. Radiographs of 17 patients (5.6%) revealed intraesophageal retention of the tablet, and their prompt evaluation with double-contrast esopha grams confirmed various structural or functional abnormalities in 15 p atients. Therefore, the oral administration of a barium tablet during routine chest radiography is a simple efficacious method to assess eso phageal patency and detect occult narrowings from structural or functi onal causes.