Filling defects Intraluminal lesion A lesion that lies within the bowel lumen and is entirely surrounded by barium. UNIT VII1 Fig. shows Duodenal carcinoid

Extra luminal lesion Arises from outside + compresses the bowel. Causes narrowing from one side only. Forms a shallow angle with the bowel wall. UNIT VII2

Strictures Annular narrowing  Benign esophageal stricture (without shoulder).  Malignant. UNIT VII3

Ulceration Injury of the mucosal surface which becomes visible when the crater الحفرة filled with barium. UNIT VII4

Esophagus The patient swallows Ba paste. The flow is observed on T.V. monitor films are taken. With the esophagus full to show esophageal wall and to follow the passage of Ba. With the esophagus empty to show the mucosal folds. UNIT VII5 Barium swallow

Esophageal abnormalities (lesions) Configurationally changes. Filling defects. Ulcerations. Diverticulae. Strictures. UNIT VII8

Configurationally changes Displacements Due to mass in the chest or the mediastinum. UNIT VII9

Motility disorders 1. Tertiary contraction Non propulsive contraction waves not occurring in an orderly fashion. Corkscrew esophagus UNIT VII10

2. Achalasia of the cardia is an esophageal motility disorder involving the smooth muscle layer of the esophagus and the lower esophageal sphincter (LES). It is characterized by incomplete LES relaxation, and lack of peristalsis of the esophagus (inability of smooth muscle to move food down the esophagus) in the absence of other explanations like cancer or fibrosis. UNIT VII11

UNIT VII12

Filling defects Benign lesions. Malignant lesion. UNIT VII13 Inflammatory Polyps of the Esophagus A polyp: is an abnormal growth of tissue projecting from a mucous membrane.

Strictures Corrosive in the upper part (benign). Peptic in the lower part. Malignant. Corrosive stricture UNIT VII15

Diverticular disease Sac branching out from the esophagus mainly seen in the thoracic portion of the esophagus. UNIT VII16 e.g. Zenker diverticulum Mouth is continuous with the diverticulum So the food is stored in it.

Stomach and Duodenum The patient comes fasting before the exam 6 hours. Barium meal (not so fluid not so solid) involves coating the lining of a stomach, which has been distended with gas UNIT VII17

UNIT VII18