Photo Hunters : “Drink”
We often take for granted the simple act of drinking. Where does the drink go? Here’s a drink of barium, which shows on an X-ray. This is done to diagnose patients with difficulty in swallowing.
A barium swallow, showing the passage of barium down… behind the voice box and down the oesophagus
However, this patient couldn’t swallow properly, food and drinks get stuck in the throat. See the bulge marked with red? That’s a tumour blocking the smooth passage of food down the oesophagus. So, be happy that you can swallow well.. it’s something that we don’t even think twice about when we drink.
Now, what are the risk factors of oesophageal cancer? Among them are cigarette smoking, gastro-oesophageal reflux and too much of these:
A hard message to swallow but as Mary Poppins says, “A spoonful of sugar makes the medicine go down.”
Eventually, after drinking, the water goes gets excreted. The majority of the water excretion is done via the urine. A urogram shows the passage of urine from the kidneys at the top to the bladder at the bottom.
Quite an x-ray education.
As usual an informative Photo Hunt. Happy weekend.
Wow. Nice x-ray there
I think it’s very cool we can visit here for something “different”. I like to learn new things and find it cool you have these xrays to share.
Happy St. Patty’s! Thanks for getting Mary Poppins in my head! LOL
Hi all, it fun to put up something different. Happy St Patrick’s day to you too.
Hmm.. I was just thinking… is barium swallow a common practice in M’sia? As far as I know, barium swallow do come with some risks? Would a water soluble radiocontrast much safer?
Err .. didn’t quite get the meaning. What is barium? Is it a special drink to enable the pic taking of patient throat passage on to the x-ray film?
Great twist to the topic.
Acidulous, barium swallow is the more commonly-used contrast for swallow studies.
1. gastrograffin is not safer than barium in the event of aspiration.
2. gastrograffin is costlier.
Sometimes, to look for post-oesophagectomy anastomotic leaks, gastrograffin is used. Even then, barium is more sensitive than gastrograffin. See abstract from Fan ST, Lau WY, et al. In fact, this study showed that barium was safer than gastrograffin.
hoiling, barium is a drink that is visible on x-ray. So taking a series of x-rays while drinking barium can show how the swallowing process is abnormal. … or normal.
George, would an upper GI enthusiast like to comment on the relative merits gastrograffin and barium swallow?
Hmm…recently I drink socially on occassions…but too much when emotionally…at risk too?
Thanks for the info… another questions? why the radiologist alway say that barium will be phase out sooner or later? Why are they concern about barium poisoining if Barium in its insoluble form is harmless?
What a wonderful picture for the theme. I saw that deviation in the esophagus and thought tumor. It looks more like an intrinsic esophageal lesion rather than an enlarged lymph node or extrinsic tumor. Do you see a lot of esophageal cancer there?
Chelsea, good that you know you’ve had too much. Don’t let it control you.
acidulous, everything that we do now will be phased out sooner or later, don’t you think?
The barium sulphate that is used for radiocontrast is insoluble, which is harmless. But there are toxicity associated with soluble barium. Of course, there are conditions where barium is contraindicated, that’s why there are water-soluble contrast available for those indications.
srp, you’re right, it’s an esophageal squamous cell carcinoma at the junction of the upper and middle third. I don’t see that many, probably about 1 or 2 a year. But I refer them to the surgeons in the big centre to get the esophagectomy done. Or refer them to the gastroenterologist for stenting if not resectable.
The incidence of esophageal cancer in Malaysia is 2.3 per 100,000 per year. Compare that to China with a rate of 26.2 per 100,000 per year.