Presentation
Severe dysphagia and choking. Recent weight loss.
Patient Data
Segmental stricture with shouldering is present in the proximal esophagus, measuring about 3 cm in length, which causes marked luminal narrowing and contrast media aspiration, most consistent with malignant tumoral infiltration.
Case Discussion
In a fluoroscopic study, malignant esophageal strictures characteristically appear abrupt, asymmetric, and eccentric with irregular, nodular mucosa. However, tapered margins may occur with malignant lesions because of the ease of submucosal spread of a tumor.
Barium aspiration occurs occasionally during upper GI fluoroscopic studies. It is one of the essentials to look for during barium swallow examinations, and it can lead to secondary pneumonia and, subsequently, respiratory distress.
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