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What is A 60 yrs old pt presenting with dysphagia of 6 wks duration with solid foods. Now can swallow only liquids. Investigations done to diagnose here ? and explain in detail?
Ans is 'a' i.e. CXR; 'b' i.e. Ba- swallow; 'c' i.e. Endoscopy A progressive dysphagia first for solid only and later for liquids also, suggests mechanical obstruction such as carcinoma or peptic stricture. Patients with peptic stricture give h/o chronic reflux disease. So this is most probably a case of carcinoma. Investigations done in Ca esophagus Chest X-ray can show metastasis, plural effussion or complication of aspiration (pneumonia, lung abscess) Ba swallow this is the first investigation for any esophageal disease it can show - irregular filling defect with or without proximal dilatation. - annular lesion appear as constricting bands CT scan - are useful to diagnose liver metastasis, and lymph node involvement. Can also show the local spread of Ca. Esophageal endosonography - is quite accurate in determination of wall penetration and mediastinal invasion. Endoscopy & biopsy - this is the investigation of choice for esophageal Ca.