esophagram

• AP/PA

  supine or prone

  have the patient swallow several mouthfuls of barium in succession. hold one mouthful of barium until immediately before exposure.

  CR: perpendicular to the IR entering MSP at the level of T5/T6
• PA oblique

  erect or prone facing IR, 35-40 degree RAO position (or LPO)

  have the patient swallow several mouthfuls of barium in succession. hold one mouthful of barium until immediately before exposure

  CR: perpendicular to the IR entering 2" lateral to the upside of MSP at the level of T5/6
• PA Oblique

  erect or prone facing the IR, 35-40 degree LAO

  have the patient swallow several mouthfuls of barium in succession. hold one mouthful of barium until immediately before exposure

  CR: perpendicular to the IR entering 2" lateral to the upside of MSP at the level of T5/6
• lateral

  left lateral position, recumbent or upright

  have the patient swallow several mouthfuls of barium in succession. hold one mouthful of barium until immediately before exposure

  CR: perpendicular to the IR entering MCP at the level of T5/6
• indications

  dysphagia (difficulty swallowing)

  achalasia (failure or smooth muscle to relax, not allow passage to stomach)

  carcinoma

  FB

  GERD (gastroesophageal reflux disease)

  esophageal varices (dilated submucosal vein)

  Zenker diverticulum (outpouching of mucous membrane of the esophagus)
• why valsalva maneuver

  evaluate reflux and the pressure on the eg junction