Radiologic evaluation of esophageal dysphagia.

In patients with dysphagia, the radiographic examination evaluates both structural and functional abnormalities of the esophagus. Radiologic examination is more appropriate than endoscopy for initial screening of patients with dysphagia (Table 6). Endoscopy is more expensive, generally requires sedation, and is associated with a small but definite risk to the patient. Also, the endoscopic examination yields a poor evaluation of esophageal motor function and may fail to detect mucosal rings and peptic strictures, especially if smaller caliber instruments are used. The chief limitations of the radiographic examination are poor detection of mild cases of esophagitis and variable sensitivity and specificity in diagnosing esophageal motor disorders.