Characteristics of Patients With Esophageal Dysphagia Assessed by Chest X-Ray Imaging After Videofluoroscopic Swallowing Study

Abstract

Objective To evaluate the prevalence rate, types, characteristics, and associated factors of esophageal dysphagia detected on chest X-ray images after videofluoroscopic swallowing study (VFSS).Methods The medical records of 535 adults were reviewed retrospectively. Chest X-ray images taken after barium swallow study were analyzed and presence of any residual barium in the esophagus was considered as esophageal dysphagia. Esophageal dysphagia was classified based on the largest width of barium deposit (mild, <2 cm; severe ≥2 cm) and the anatomic level at which it was located (upper and lower esophagus).Results Esophageal residual barium on chest X-ray images was identified in 40 patients (7.5%, 40/535). Esophageal dysphagia was more frequent in individuals aged 65–79 years (odds ratio=4.78, p<0.05) than in those aged <65 years. Mild esophageal dysphagia was more frequent (n=32) than its severe form (n=8). Lower esophageal dysphagia was more frequent (n=31) than upper esophageal dysphagia (n=9). Esophageal residual barium in patients diagnosed with esophageal cancer or lung cancer was significantly associated with severe esophageal dysphagia (p<0.05) and at the upper esophagus level (p<0.01).Conclusion Esophageal residual barium was observed on chest X-ray imaging after VFSS. Esophageal barium in the upper esophagus with a diameter of ≥2 cm is an important indicator of malignancy, and chest X-ray image taken after VFSS is an important step to evaluate the presence of esophageal disorder.

Esophageal Motility Disorders in Patients With Esophageal Barium Residue After Videofluoroscopic Swallowing Study

“…In this analysis, the proportion of subjects with esophageal barium greater than 1 cm was 19% of the subjects, which was even higher than the previously reported 7.5% with presence of esophageal barium residue regardless of the size of diameter [6]. The previous study showed significant differences in the age of subjects based on the presence or absence of esophageal barium residues [6]. The average age of the study population in the previous study was 73.5 years, and the age of population in this study was slightly older (mean age was 74.7 years).…”

“…Videofluoroscopic swallowing studies (VFSS) are one of the standard tests to evaluate pharyngeal swallowing function. We previously reported 7.5% of the patients undergoing the test showed some degree of esophageal dysphagia [ 6 ]. When barium in the esophagus with a diameter of 2 cm or more was observed after the VFSS test, lung cancer and esophageal cancer were confirmed through esophagogastroduodenoscopy (EGD) or chest computed tomography (CT) scan, and achalasia was confirmed through barium esophagogram [ 6 ].…”

“…We hypothesized that there would be esophageal motility disorders in patients with post-VFSS barium residues greater than 1 cm. In addition, we hypothesized that a significant number of patients undergoing the VFSS test may have difficulties in receiving the HREM due to pre-existing cognitive or physical impairments [ 6 ]. In this study, we aimed to confirm the presence of esophageal motility disorders by reviewing the results of HREM in subjects with a diameter of 1 cm or more of barium residue in the esophagus, and to determine the proportion of major motility disorders requiring active treatment attempts.…”

Application Value of Gastroenterography Combined With CT in the Evaluation of Short-Term Efficacy and Prognosis in Patients With Esophageal Cancer Radiotherapy

“…This examination is usually used for patients who cannot tolerate or cannot undergo gastrointestinal endoscopy. It has the advantages of relative safety, no side effects, and simple operation ( 11 ). Gastroenterography is widely used in clinical diagnosis and treatment.…”

Dysphagia Secondary to Esophageal Compression in a Patient with Decompensated Heart Failure

“…12 Authors have previously suggested that residual esophageal barium in a chest radiograph routinely taken immediately after VFSS could indicate esophageal dysphagia. 13 Cardiogenic dysphagia can be suspected if there is a history of previous heart disease and if evidence of cardiomegaly is present on the chest radiograph. If esophageal dysphagia is suspected, assessment for abnormalities may be done through esophagogastroduodenoscopy and manometry.…”