Esophageal perforation: comparison of use of aqueous and barium-containing contrast media.
OBJECTIVE
To assess the need for follow-up esophagography with barium-containing contrast medium after examination with a water-soluble contrast medium in the detection of esophageal perforation.


METHODS
Sixty-seven patients suspected of having esophageal perforation were examined prospectively with use of an aqueous contrast medium during a 1-year period. The examinations were performed with a digital fluoroscopy unit. Eighteen patients without proved extravasation at esophagography performed with aqueous contrast medium and without other contraindications underwent esophagography with barium-containing contrast medium.


RESULTS
In four of 18 patients (22%) with unremarkable findings at esophagography performed with a water-soluble contrast medium, a perforation was detected subsequently with use of a barium-containing contrast medium. No complications related to barium extravasation occurred.


CONCLUSIONS
Patients suspected of having esophageal perforation and who have unremarkable findings at esophagography with water-soluble contrast media need to undergo follow-up esophagography with a barium-containing contrast medium. The use of a digital fluoroscopy unit does not obviate the follow-up examination.
Buecker
A
A
Clinic for Diagnostic Radiology, University of Technology Aachen, Germany.
Wein
B B
BB
Neuerburg
J M
JM
Guenther
R W
RW
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001466:Barium Sulfate; D003287:Contrast Media; D004939:Esophageal Perforation / Q000000981:diagnostic imaging*; D004947:Esophagus / Q000000981:diagnostic imaging; D005260:Female; D005471:Fluoroscopy; D006801:Humans; D007479:Iopamidol; D007483:Iothalamic Acid / Q000031:analogs & derivatives; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011856:Radiographic Image Enhancement; D012995:Solubility
D003287:Contrast Media; D007483:Iothalamic Acid; D001466:Barium Sulfate; C002587:ioxitalamic acid; D007479:Iopamidol