Barium or gastrografin: which contrast media for diagnosis of esophageal tears?

In order to study the effects of the commonly employed contrast media alone and in combination with bacteria in the mediastinum, various mixtures of barium and meglamine diatrizoate (Gastrografin) with and without flora were instilled in the mediastinum of 29 domestic cats. The animals were killed for pathological studies at serial time intervals following mediastina injection. These data demonstrate that water-soluble contrast media cause no significant histological reaction. Barium causes granuloma formation but has no additional deleterious effects when mixed with flora. Barium has superior physical properties of mucosal coating and radiographic density. It should be employed as the contrast agent of choice in difficult clinical problems with regard to esophageal tears. A water-soluble contrast study of the esophagus may be utilized as the initial diagnostic procedure, but if this is normal a follow-up barium esophagram is recommended.