title: Esophageal perforation: comparison of use of aqueous and barium-containing contrast media.
abstract: 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.
authors.affiliation: Clinic for Diagnostic Radiology, University of Technology Aachen, Germany.
authors.forename: A
authors.initials: A
authors.lastname: Buecker
authors.forename: B B
authors.initials: BB
authors.lastname: Wein
authors.forename: J M
authors.initials: JM
authors.lastname: Neuerburg
authors.forename: R W
authors.initials: RW
authors.lastname: Guenther
mesh_terms: 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
chemical_list: D003287:Contrast Media; D007483:Iothalamic Acid; D001466:Barium Sulfate; C002587:ioxitalamic acid; D007479:Iopamidol