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Radiological Findings

Chest and abdomen radiographs are obtained to screen for signs of perforation. The initial radio-

Fig. 2.26. Alkali ingestion. Barium swallow shows a long segment of narrowing of the mid esophagus approximately 3 weeks after swallowing drain cleaner

Fig. 2.26. Alkali ingestion. Barium swallow shows a long segment of narrowing of the mid esophagus approximately 3 weeks after swallowing drain cleaner

logic examination is the esophagram which is best performed with water soluble non-ionic isotonic contrast medium in case of perforation. The earliest signs are epiglottic swelling, esophageal dys-motility, mucosal edema and ulceration (Fig. 2.27). Intramural contrast and persistent gaseous dilatation of the esophagus are signs of severe injury and may precede perforation (Fernbach 1994). CT is recommended if suspicion for perforation is high. Deep esophageal burns are investigated by serial esophagrams to detect early stricture formation. Follow up barium esophagrams are important to evaluate the development of scarring and the length of the resulting strictures which are typically long.

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