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== Overview ==
== Overview ==
Contrast [[esophagogram]] usually establishes the diagnosis of an [[Boerhaave syndrome|esophageal perforation]], the location and extent of [[perforation]]. The accuracy of the test depends on the size and location of the [[perforation]] and the technique used for the study. [[Gastrografin]], a water-soluble [[contrast]] is used for the esophagogram [[procedure]]. If the [[Gastrografin]] [[esophagogram]] is inconclusive, a [[Barium chloride|barium esophagogram]] should be performed. [[Gastrografin]] is preferred over the [[Barium chloride|barium esophagogram]] to prevent barium induced inflammatory response in [[mediastinum]] and [[pleural space]], whereas [[barium]] esophagogram is very efficient in picking the small [[Perforation|perforations]].


== Diagnostic Study of Choice ==
== Diagnostic Study of Choice ==
===== Template statements =====
=== Study of choice: ===
=== Study of choice: ===
* [Name of the investigation] is the gold standard test for the diagnosis of [disease name].
*Contrast Esophagram usually establishes the diagnosis of an [[esophageal perforation]]:<ref name="pmid3753071">{{cite journal |vauthors=Bladergroen MR, Lowe JE, Postlethwait RW |title=Diagnosis and recommended management of esophageal perforation and rupture |journal=Ann. Thorac. Surg. |volume=42 |issue=3 |pages=235–9 |year=1986 |pmid=3753071 |doi= |url=}}</ref><ref name="pmid7089304">{{cite journal |vauthors=Dodds WJ, Stewart ET, Vlymen WJ |title=Appropriate contrast media for evaluation of esophageal disruption |journal=Radiology |volume=144 |issue=2 |pages=439–41 |year=1982 |pmid=7089304 |doi=10.1148/radiology.144.2.7089304 |url=}}</ref><ref name="pmid1126592">{{cite journal |vauthors=James AE, Montali RJ, Chaffee V, Strecker EP, Vessal K |title=Barium or gastrografin: which contrast media for diagnosis of esophageal tears? |journal=Gastroenterology |volume=68 |issue=5 Pt 1 |pages=1103–13 |year=1975 |pmid=1126592 |doi= |url=}}</ref><ref name="pmid1193339">{{cite journal |vauthors=Schwartz SS |title=Letter: Barium or gastrografin: which contrast media for diagnosis of esophageal tears? |journal=Gastroenterology |volume=69 |issue=6 |pages=1377 |year=1975 |pmid=1193339 |doi= |url=}}</ref><ref name="pmid1115308">{{cite journal |vauthors=Vessal K, Montali RJ, Larson SM, Chaffee V, James AE |title=Evaluation of barium and gastrografin as contrast media for the diagnosis of esophageal ruptures or perforations |journal=Am J Roentgenol Radium Ther Nucl Med |volume=123 |issue=2 |pages=307–19 |year=1975 |pmid=1115308 |doi= |url=}}</ref>
* The following result of [gold standard test] is confirmatory of [disease name]:
**The location and  
** Result 1
**Extent of [[perforation]] 
** Result 2
*The accuracy of the test depends on:
* The [name of the investigation] should be performed when:
**The size and location of the [[perforation]]
** The patient presented with symptoms/signs 1. 2, 3.
**The technique used for the study
** A positive [test] is detected in the patient.
*[[Gastrografin]] is a water-soluble contrast used for the [[esophagogram]] procedure.
* [Name of the investigation] is the gold standard test for the diagnosis of [disease name].
*If the [[Gastrografin]] [[esophagogram]] is inconclusive, a [[barium]] [[esophagogram]] should be performed.  
* The diagnostic study of choice for [disease name] is [name of the investigation].
*[[Gastrografin]] is preferred over the [[barium]] [[esophagram]] to prevent [[barium]] induced [[inflammatory]] response in [[mediastinum]] or [[Pleural space|pleural spaces]], whereas [[barium]] [[esophagram]] is very efficient in picking the small [[Perforation|perforations]].
* There is no single diagnostic study of choice for the diagnosis of [disease name].
*[[Barium]] esophagram can detect
* There is no single diagnostic study of choice for the diagnosis of [disease name], but [disease name] can be diagnosed based on [name of the investigation 1] and [name of the investigation 2].
**Sixty percent of [[cervical]] [[Perforation|perforations]]  
* [Disease name] is mainly diagnosed based on clinical presentation.
**Ninety percent of [[intrathoracic]] perforations.
* Investigations:
** Among patients who present with clinical signs of [disease name], the [investigation name] is the most specific test for the diagnosis.
** Among patients who present with clinical signs of [disease name], the [investigation name] is the most sensitive test for diagnosis.
** Among patients who present with clinical signs of [disease name], the [investigation name] is the most efficient test for diagnosis.
 
==== The comparison table for diagnostic studies of choice for [disease name] ====
{|
|- style="background: #4479BA; color: #FFFFFF; text-align: center;"
! style="background: #FFFFFF; color: #FFFFFF; text-align: center;" |
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Sensitivity
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Specificity
|-
! style="background: #696969; color: #FFFFFF; text-align: center;" |Test 1
| style="background: #DCDCDC; padding: 5px; text-align: center;" |✔
| style="background: #DCDCDC; padding: 5px; text-align: center;" |...%
|-
! style="background: #696969; color: #FFFFFF; text-align: center;" |Test 2
| style="background: #DCDCDC; padding: 5px; text-align: center;" |...%
| style="background: #DCDCDC; padding: 5px; text-align: center;" |✔
|}
<small> ✔= The best test based on the feature </small>
 
===== Diagnostic results =====
The following result of [investigation name] is confirmatory of [disease name]:
* Result 1
* Result 2
 
===== Sequence of Diagnostic Studies =====
The [name of investigation] should be performed when:
* The patient presented with symptoms/signs 1, 2, and 3 as the first step of diagnosis.
* A positive [test] is detected in the patient, to confirm the diagnosis.
 
=== Diagnostic Criteria ===
* Here you should describe the details of the diagnostic criteria.
*Always mention the name of the criteria/definition you are about to list (e.g. modified Duke criteria for the diagnosis of endocarditis / 3rd universal definition of MI) and cite the primary source of where this criteria/definition is found.
*Although not necessary, it is recommended that you include the criteria in a table. Make sure you always cite the source of the content and whether the table has been adapted from another source.
*Be very clear as to the number of criteria (or threshold) that needs to be met out of the total number of criteria.
*Distinguish criteria based on their nature (e.g. clinical criteria / pathological criteria/ imaging criteria) before discussing them in details.
*To view an example (endocarditis diagnostic criteria), click [[Endocarditis diagnosis|here]]
*If relevant, add additional information that might help the reader distinguish various criteria or the evolution of criteria (e.g. original criteria vs. modified criteria).
*You may also add information about the sensitivity and specificity of the criteria, the pre-test probability, and other figures that may help the reader understand how valuable the criteria are clinically.
* [Disease name] is mainly diagnosed based on clinical presentation. There are no established criteria for the diagnosis of [disease name].
* There is no single diagnostic study of choice for [disease name], though [disease name] may be diagnosed based on [name of criteria] established by [...].
 
* The diagnosis of [disease name] is made when at least [number] of the following [number] diagnostic criteria are met: [criterion 1], [criterion 2], [criterion 3], and [criterion 4].
* The diagnosis of [disease name] is based on the [criteria name] criteria, which includes [criterion 1], [criterion 2], and [criterion 3].
 
* [Disease name] may be diagnosed at any time if one or more of the following criteria are met:
** Criteria 1
** Criteria 2
** Criteria 3
 
IF there are clear, established diagnostic criteria:
*The diagnosis of [disease name] is made when at least [number] of the following [number] diagnostic criteria are met: [criterion 1], [criterion 2], [criterion 3], and [criterion 4].
*The diagnosis of [disease name] is based on the [criteria name] criteria, which include [criterion 1], [criterion 2], and [criterion 3].
*The diagnosis of [disease name] is based on the [definition name] definition, which includes [criterion 1], [criterion 2], and [criterion 3].
IF there are no established diagnostic criteria: 
*There are no established criteria for the diagnosis of [disease name].


<gallery>
Image: Gastrografin.jpeg|'''Gastrografin Esophagram: With the ingestion of Gastrografin, a right-sided oesophageal leak into the pleural space quickly occurs. The leak crosses over slightly into the left pleural space and extends a little into the retrocrural/retroperitoneal space as well.; Source- Radiopaedia'''
</gallery>


==References==
==References==

Latest revision as of 19:13, 17 February 2021

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Ajay Gade MD[2]], Feham Tariq, MD [3]

Overview

Contrast esophagogram usually establishes the diagnosis of an esophageal perforation, the location and extent of perforation. The accuracy of the test depends on the size and location of the perforation and the technique used for the study. Gastrografin, a water-soluble contrast is used for the esophagogram procedure. If the Gastrografin esophagogram is inconclusive, a barium esophagogram should be performed. Gastrografin is preferred over the barium esophagogram to prevent barium induced inflammatory response in mediastinum and pleural space, whereas barium esophagogram is very efficient in picking the small perforations.

Diagnostic Study of Choice

Study of choice:

  • Gastrografin Esophagram: With the ingestion of Gastrografin, a right-sided oesophageal leak into the pleural space quickly occurs. The leak crosses over slightly into the left pleural space and extends a little into the retrocrural/retroperitoneal space as well.; Source- Radiopaedia
    Gastrografin Esophagram: With the ingestion of Gastrografin, a right-sided oesophageal leak into the pleural space quickly occurs. The leak crosses over slightly into the left pleural space and extends a little into the retrocrural/retroperitoneal space as well.; Source- Radiopaedia

References

  1. ↑ Bladergroen MR, Lowe JE, Postlethwait RW (1986). "Diagnosis and recommended management of esophageal perforation and rupture". Ann. Thorac. Surg. 42 (3): 235–9. PMID 3753071.
  2. ↑ Dodds WJ, Stewart ET, Vlymen WJ (1982). "Appropriate contrast media for evaluation of esophageal disruption". Radiology. 144 (2): 439–41. doi:10.1148/radiology.144.2.7089304. PMID 7089304.
  3. ↑ James AE, Montali RJ, Chaffee V, Strecker EP, Vessal K (1975). "Barium or gastrografin: which contrast media for diagnosis of esophageal tears?". Gastroenterology. 68 (5 Pt 1): 1103–13. PMID 1126592.
  4. ↑ Schwartz SS (1975). "Letter: Barium or gastrografin: which contrast media for diagnosis of esophageal tears?". Gastroenterology. 69 (6): 1377. PMID 1193339.
  5. ↑ Vessal K, Montali RJ, Larson SM, Chaffee V, James AE (1975). "Evaluation of barium and gastrografin as contrast media for the diagnosis of esophageal ruptures or perforations". Am J Roentgenol Radium Ther Nucl Med. 123 (2): 307–19. PMID 1115308.

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