Line 18:
Line 18: ===Preferred Table===
===Preferred Table===
{| class="wikitable"
{| class="wikitable"
! rowspan="3" align="center" style="background:#4479BA; color: #FFFFFF;" |Disease
! rowspan="3" align="center" style="background:#4479BA; color: #FFFFFF;" |Disease
Line 62:
Line 63: |
|
* [[Biopsy]]
* [[Biopsy]]
|-
| style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Plummer-Vinson syndrome]]
|
* Gradual
| +
| -
|Non progressive
| +/-
| -
|
* [[Glossitis]]
* [[Koilonychia]]
|Normal
|
* Thin projections on the anterior [[esophageal]] wall
* Multiple upper [[Esophageal stricture|esophageal constrictions]]
[[Image:Plummer-vinson-syndrome.jpg|center|200px|thumb|Barium esophagogram (Source: Case courtesy of Dr Hani Salam, <a href="https://radiopaedia.org/">Radiopaedia.org</a>. From the case <a href="https://radiopaedia.org/cases/14029">rID: 14029</a>)]]
|
* Direct visualization of [[esophageal webs]]
* Superior to [[esophagogram]]
<div style="width:350px">{{#ev:youtube|HFfsTgsB6Pg}}</div>
|
* Videofluoroscopy shows [[mucosal]] and [[submucosal]] foldings
|
Triad of
* [[Iron deficiency anemia]]
* [[Esophageal webs]]
* [[Glossitis]]
|-
| style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Esophageal stricture]]
|
* Gradual
* Sudden onset
| +
| -
|Progressive
| +/-
| +/-
|
* [[Odynophagia]]
* [[Cough]]
* [[Chest pain]]
|Normal
|
*Sacculations
*Fixed transverse folds
*[[Esophageal]] intramural pseudodiverticula
[[Image:Benign-oesophageal-stricture.jpg|center|200px|thumb|Case courtesy of Dr Ahmed Abd Rabou, Radiopaedia.org, rID: 23008]]
|
* [[Mucosal]] edema
* Circumferential thickening in [[Gastroesophageal reflux disease|GERD]]
* Pale [[mucosa]] with white [[exudate]] in lymphocytic esophagitis
* [[Swelling]] and [[hemorrhagic]] [[congestion]] in [[caustic]]<nowiki/> ingestion
<div style="width:350px">{{#ev:youtube|vax5E-jMnQ}}</div>
|
* [[Manometry]] may show dysmotility
* [[CT scan]] for staging [[malignant]] [[strictures]]
|
* [[Esophagogram|Barium esophagogram]]
|-
| style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Diffuse esophageal spasm]]
|
* Sudden
|<nowiki>+</nowiki>
|<nowiki>+</nowiki>
|Non progressive
|<nowiki>+</nowiki>
|<nowiki>+</nowiki>
|
* [[Chest pain]]
|Normal
|
* Nonperistaltic and nonpropulsive contractions
* Corkscrew or rosary bead esophagus
[[Image:DES radio.png|center|200px|thumb|Barium swallow appearance of DES<br>Source:By Nevit Dilmen [CC BY-SA 3.0 (https://creativecommons.org/licenses/by-sa/3.0)]]
|
* Inconclusive
<div style="width:350px">{{#ev:youtube|2ipA34iMA3c}}</div>
|
*[[Manometry]] shows high-amplitude [[esophageal]] contractions
*[[CT scan]] may show [[hypertrophy]] of esophageal muscles
|
* [[Manometry]]
|-
| style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Achalasia]]
|
* Gradual
| +
|<nowiki>+</nowiki>
|Non progressive
| +/-
| -
|
* [[Regurgitation]] of undigested food
* [[Chest pain]]
|Normal
|
* "Bird's beak" or "rat tail" appearance
* Dilated esophageal body
* Air fluid level (absent [[peristalsis]])
* Absence of an intragastric air bubble
[[Image:Achalasia-2.jpg|center|200px|thumb|Case courtesy of Dr Mario Umana, Radiopaedia.org, rID: 38071]]
|
* Dilated [[esophagus]]
* Residual food fragments
* Normal [[mucosa]]
<div style="width:350px">{{#ev:youtube|ydLcskQzEjM}}</div>
|
* Residual pressure of [[Lower esophageal sphincter|LES]] > 10 mmHg
* Incomplete relaxation of the [[Lower esophageal sphincter|LES]]
* Increased resting tone of [[Lower esophageal sphincter|LES]]
* Aperistalsis
|
* History of [[dysphagia]] with positive [[endoscopy]] and [[manometry]]
|-
|-
| style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Systemic sclerosis]]
| style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Systemic sclerosis]]
Line 216:
Line 97: |
|
* [[Skin biopsy]]
* [[Skin biopsy]]
|-
| style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Zenker's diverticulum]]
|
* Gradual
| +
|<nowiki>-</nowiki>
|
| +/-
| -
|
* Food [[regurgitation]]
* [[Halitosis]]
* [[Coughing|Cough]]
* [[Hoarseness]]
|Normal
|
* Thin projections on [[esophageal]] wall over [[Killian's dehiscence|Killian's triangle]]
[[Image:Zenker-4.jpg|center|200px|thumb| Radiopaedia.org">{{cite web |url=https://radiopaedia.org/cases/zenker-diverticulum |title=Zenker diverticulum | Radiology Case | Radiopaedia.org |format= |work= |accessdate=}}<nowiki></ref></nowiki>]]
|
* Outpouching of posterior [[pharyngeal]] wall
* Exclude the presence of [[Squamous cell carcinoma|SCC]]
<div style="width:350px">{{#ev:youtube|FdEruFsNdVA}}</div>
|
* [[CT]] & [[MRI]] shows out-pouching over the posterior esophagus in the Killian's triangle
|
* Barium [[Esophagogram|esophagography]]
|-
|-
| style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Stroke]]
| style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Stroke]]
Line 326:
Line 177: |
|
* 24 hour [[esophageal]] pH monitoring
* 24 hour [[esophageal]] pH monitoring
|-
| style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Esophageal web]]
|
* Gradual
| +
| +/-
|Progressive
| -
| +/-
|
* Findings of the underlying cause such as [[iron deficiency anemia]] or [[bullous pemphigoid]]
|Normal
|
* Symmetrical narrowing of the [[esophagus]]
|
* Smooth membrane not encircling the whole [[Lumen (anatomy)|lumen]]
|
* Videofluoroscopy shows [[mucosal]] and [[submucosal]] foldings
|
* Barium [[esophagogram]]
|}
|}
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] ; Associate Editor(s)-in-Chief: Amresh Kumar MD [2]
Overview Barrett's Oesophagus must be differentiated from Esophagitis , Peptic ulcer disease and Esophageal motor disorders.
Differentiating Barrett's Esophagus from other Diseases Pills esophagitis
Eosinophilic esophagitis Infectious esophagitis[ 1]
Preferred Table
Disease
Signs and Symptoms
Barium esophagogram
Endoscopy
Other imaging and laboratory findings
Gold Standard
Onset
Dysphagia
Weight loss
Heartburn
Other findings
Mental status
Solids
Liquids
Type
Esophageal carcinoma
+
+
Progressive
+
+/-
Normal
Case courtesy of Dr Bruno Di Muzio, Radiopaedia.org, rID: 4232f
{{#ev:youtube|5ucSlgqGAno}}
CT and PET scan is an optional test for staging of the disease
Systemic sclerosis
+
+
Progressive
+/-
+
Normal
Peptic stricture (advanced cases)
Positive serology for
Stroke
(Cerebral hemorrhage )
+
+
Progressive
+
+/-
Impaired
Motor disorders
(Myasthenia gravis )
+
+
Progressive
+/-
Normal
Stasis in pharynx and pooling in pharyngeal recesses
Anti–acetylcholine receptor antibody test
GERD
+
-
Progressive
+/-
+
Normal
Use if the above table can not be made
Differential Diagnosis
Similar Features
Differentiating Features
Differential 1
On [physical exam; history; diagnostic test; imaging], [Differential 1] {has; demonstrates} [feature 1], [feature 2], [feature 3] also observed in [disease name].
On [physical exam; history; diagnostic test; imaging], [Differential 1] {has; demonstrates} [feature 1], [feature 2], [feature 3] that distinguish it from [disease name].
Differential 2
On [physical exam; history; diagnostic test; imaging], [Differential 1] {has; demonstrates} [feature 1], [feature 2], [feature 3] also observed in [disease name].
On [physical exam; history; diagnostic test; imaging], [Differential 1] {has; demonstrates} [feature 1], [feature 2], [feature 3] that distinguish it from [disease name].
Differential 3
On [physical exam; history; diagnostic test; imaging], [Differential 1] {has; demonstrates} [feature 1], [feature 2], [feature 3] also observed in [disease name].
On [physical exam; history; diagnostic test; imaging], [Differential 1] {has; demonstrates} [feature 1], [feature 2], [feature 3] that distinguish it from [disease name].
Differential 4
On [physical exam; history; diagnostic test; imaging], [Differential 1] {has; demonstrates} [feature 1], [feature 2], [feature 3] also observed in [disease name].
On [physical exam; history; diagnostic test; imaging], [Differential 1] {has; demonstrates} [feature 1], [feature 2], [feature 3] that distinguish it from [disease name].
Differential 5
On [physical exam; history; diagnostic test; imaging], [Differential 1] {has; demonstrates} [feature 1], [feature 2], [feature 3] also observed in [disease name].
On [physical exam; history; diagnostic test; imaging], [Differential 1] {has; demonstrates} [feature 1], [feature 2], [feature 3] that distinguish it from [disease name].
References Template:WH
Template:WS
