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Short-Segment Barrett's Esophagus

Findings on Double-Contrast Esophagography in 20 Patients

¹ Department of Radiology, Hospital of the University of Pennsylvania, 3400 Spruce St., Philadelphia, PA 19104.
² Department of Medicine, Hospital of the University of Pennsylvania, Philadelphia, PA 19104.
³ Department of Pathology and Laboratory Medicine, Hospital of the University of Pennsylvania, Philadelphia, PA 19104.

View larger version (68K): [in a new window]   Fig. 1. —71-year-old woman with short-segment Barrett's esophagus. Upright left posterior oblique spot image from double-contrast esophagram shows granular mucosa in distal third of esophagus compatible with mild reflux esophagitis. Endoscopy performed 2 months later revealed no evidence of esophagitis, but patient had received proton pump inhibitors in interim and so subsequent healing of esophagitis was possible.

View larger version (71K): [in a new window]   Fig. 2. —61-year-old man with short-segment Barrett's esophagus. Upright left posterior oblique spot image from double-contrast esophagram shows thickened, irregular folds in distal half of esophagus compatible with reflux esophagitis. Endoscopy performed 5 months later revealed mild esophagitis with nodularity of mucosa in distal esophagus.

View larger version (74K): [in a new window]   Fig. 3. —64-year-old man with short-segment Barrett's esophagus. Upright left posterior oblique spot image from double-contrast esophagram shows tapered peptic stricture (solid white arrow) in distal esophagus. Fixed transverse folds in distal esophagus (open white arrows) are due to peptic scarring. Note tiny ulcers (black arrows) associated with reflux esophagitis. Partially collapsed hiatal hernia is seen inferiorly. Although esophagitis was not seen at endoscopy, there was a 9-month interval between these examinations.

View larger version (65K): [in a new window]   Fig. 4. —77-year-old woman with short-segment Barrett's esophagus. Upright left posterior oblique spot image from double-contrast esophagram shows short peptic stricture (curved arrow) in distal esophagus above partially collapsed hiatal hernia. Note tiny esophageal intramural pseudodiverticula (straight arrow) adjacent to stricture.

View larger version (101K): [in a new window]   Fig. 5. —52-year-old woman with short-segment Barrett's esophagus. Prone right anterior oblique spot image from single-contrast phase of esophagram shows short, slightly asymmetric peptic stricture (arrows) in distal esophagus above hiatal hernia. Rounded filling defects are air bubbles.

View larger version (82K): [in a new window]   Fig. 6. —76-year-old woman with short-segment Barrett's esophagus. Upright left posterior oblique spot image from double-contrast esophagram shows no evidence of esophagitis or peptic scarring, although this patient did have small hiatal hernia on prone views of esophagus and mild gastroesophageal reflux. Rounded filling defect in distal esophagus is air bubble.

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