Radiation Esophagitis

 Start with nonionic, low osmolar, water-soluble contrast medium (e.g., Omnipaque)

– Concern for aspiration and fistula


image Follow with barium if no leak or fistula


• Acute radiation esophagitis (RE)
image Superficial ulcers; shallow, irregular collections of barium on esophageal mucosa

image Location: Usually conforms to radiation portal

image Disordered motility, interruption of primary peristalsis

image May be seen within days to weeks of RT

• Chronic RE
image Strictures: Concentric, smooth, tapered narrowing

image Upper or mid esophagus within radiation portal

image Usually 4-8 months after completion of RT

image Late-developing deep ulcers; ominous, raising concern for fistula, especially to bronchus

image Motility disturbance may persist forever

• CT shows radiation port indirectly
image Scarring of lung in paramediastinal distribution

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Nov 16, 2016 | Posted by in GASTROINTESTINAL IMAGING | Comments Off on Radiation Esophagitis

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