of Dysphagia: Esophagoscopy vs. X-ray
M. FARIVAR, and J. L.
PERROTTO, GASTROINTESTINAL Units, NORWOOD HOSPITAL, NORWOOD,
MA, and STURDY MEMORIAL HOSPITAL, ATTLEBORO, MA
We have done a prospective study on patients with dysphagia to solids to determine
the efficacy of radiographic studies versus esophagoscopy. Eighty-one consecutive
patients in two community hospitals, referred for evaluation of dysphagia were
studied initially, with barium swallow or cine-esophagogram, or both. All patients
were then esophagoscoped with a flexible fiberoptic esophagogastroduodenoscope.
It was found: 1) Radiographic studies produced false negative results in 42%
of the cases. 2) Radiographic studies did not reveal esophageal carcinomas
in six of ten patients. 3) Flexible esophagoscopy identified the cause of dysphagia
in 100% of the patients. 4) The etiologies of dysphagia as determined by esophagoscopy
were: benign esophageal stricture - 77%; esophageal malignancy - 12%; webs
and rings - 11%. S. Endoscopic biopsies conformed a diagnosis of benign or
malignant disease in all but one patient who had gastric lymphoma metastatic
to the esophagus. These studies indicate that all patients who have dysphagia
to solids should have esophagoscopy with biopsy.