GI Radiography


Case 24 :
A 60 year old male presents with dysphagia of 3 months duration, and acute backache since 2 days.
What is the diagnosis?
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Imaging Diagnosis:

Findings reveal a long segment irregular stricture, with a linear barium streak extending outside the lumen of the mid-dorsal esophagus posteriorly. CT reveals a strictured esophagus (circumferential lesion), with a posterior mediastinal collection. A small right pleural effusion is also noted.

Ca esophagus with mediastinal abscess (mediastinitis)

Discussion:

Cancer of the esophagus remains a devastating disease because it is usually not detected until it has progressed to an advanced incurable stage. Modern imaging techniques, including barium esophagraphy, contrast-enhanced computed tomography (CT), magnetic resonance imaging (MRI), endoscopic ultrasonography (EUS), and positron-emission tomography (PET), are powerful tools in the detection, diagnosis, and staging of this malignancy. Early detection remains the elusive but essential goal of research. Only surgical resection at a very early stage has been shown to improve survival rates in patients with this disease.

Ref: http://www.emedicine.com/radio/topic271.htm

Dr. Sanjeev Mani, Bandra Holy Family Hospital, Mumbai