Presentation
Severe dysphagia. Recent weight loss. Elevated ESR and CRP.
Patient Data
Severe stricture is present in the proximal part of the oesophagus, measuring about 4 cm in length, causing almost total obstruction, and contrast medium stasis with aspiration into the trachea.
Case Discussion
The patient underwent an endoscopy, and tumoural infiltration with squamous cell carcinoma was confirmed in biopsy and histopathology evaluation.
If a patient is at risk of aspiration, the study should be performed with a low-osmolar water-soluble contrast medium (e.g. Omnipaque).
High osmolar contrast media (e.g. Gastrografin) are contraindicated due to the significant risk of flash pulmonary oedema. Though aspiration of small amounts of barium sulfate contrast medium is generally not regarded harmful, it can cause pulmonary baritosis, and aspiration of larger amounts may lead to death.
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