ESOPHAGEAL-PERFORATION - COMPARISON OF USE OF AQUEOUS AND BARIUM-CONTAINING CONTRAST-MEDIA

PURPOSE: To assess the need for follow-up esophagography with barium-c ontaining contrast medium after examination with a water-soluble contr ast medium in the detection of esophageal perforation. MATERIALS AND M ETHODS: Sisty-seven patients suspected of having esophageal perforatio n were examined prospectively with use of an aqueous contrast medium d uring a 1-year period. The examinations were performed with a digital fluoroscopy unit Eighteen patients without proved extravasation at eso phagography performed with aqueous contrast medium and without other c ontraindications underwent esophagography with barium-containing contr ast medium. RESULTS: In four of 18 patients (22%) with unremarkable fi ndings at esophagography performed with a water-soluble contrast mediu m, a perforation was detected subsequently with use of a barium-contai ning contrast medium. No complications related to barium extravasation occurred. CONCLUSION: Patients suspected of having esophageal perfora tion and who have unremarkable findings at esophagography with water-s oluble contrast media need to undergo follow-up esophagography with a barium-containing contrast medium. The use of a digital fluoroscopy un it does not obviate the follow-up examination.