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== Overview ==
== Overview ==
*Contrast Esophagram 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
**The technique used for the study.
*False-negative results occur in as many as 10 % of cases.
*Gastrografin a water-soluble contrast is used for the esophagram procedure.
*If the Gastrografin esophagram is inconclusive, a barium esophagram should be performed.
*Gastrografin is preferred over the barium esophagram to prevent barium induced inflammatory response in mediastinal or pleural cavities, whereas barium esophagram is very efficient in picking the small perforations.
*Barium esophagram can detect
**60 percent of cervical perforations
**90 percent of intrathoracic 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.
*False-negative results occur in as many as 10 % of cases.
* [Name of the investigation] is the gold standard test for the diagnosis of [disease name].
*Gastrografin a water-soluble contrast is used for the esophagram procedure.
* The diagnostic study of choice for [disease name] is [name of the investigation].
*If the Gastrografin esophagram is inconclusive, a barium esophagram should be performed.  
* There is no single diagnostic study of choice for the diagnosis of [disease name].
*Gastrografin is preferred over the barium esophagram to prevent barium induced inflammatory response in mediastinal or pleural cavities, whereas barium esophagram is very efficient in picking the small perforations.
* 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].
*Barium esophagram can detect
* [Disease name] is mainly diagnosed based on clinical presentation.
**60 percent of cervical perforations
* Investigations:
**90 percent of intrathoracic perforations.
** 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].




Revision as of 18:01, 6 February 2018

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:

Overview

  • Contrast Esophagram 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
    • The technique used for the study.
  • False-negative results occur in as many as 10 % of cases.
  • Gastrografin a water-soluble contrast is used for the esophagram procedure.
  • If the Gastrografin esophagram is inconclusive, a barium esophagram should be performed.
  • Gastrografin is preferred over the barium esophagram to prevent barium induced inflammatory response in mediastinal or pleural cavities, whereas barium esophagram is very efficient in picking the small perforations.
  • Barium esophagram can detect
    • 60 percent of cervical perforations
    • 90 percent of intrathoracic perforations.

Diagnostic Study of Choice

Study of choice:

  • Contrast Esophagram usually establishes the diagnosis of an esophageal perforation[1][2][3][4][5]
    • The location and
    • Extent of perforation
  • The accuracy of the test depends on
    • The size and location of the perforation
    • The technique used for the study.
  • False-negative results occur in as many as 10 % of cases.
  • Gastrografin a water-soluble contrast is used for the esophagram procedure.
  • If the Gastrografin esophagram is inconclusive, a barium esophagram should be performed.
  • Gastrografin is preferred over the barium esophagram to prevent barium induced inflammatory response in mediastinal or pleural cavities, whereas barium esophagram is very efficient in picking the small perforations.
  • Barium esophagram can detect
    • 60 percent of cervical perforations
    • 90 percent of intrathoracic perforations.


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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