Oesophageal varices: how reliable is a barium swallow?

Although barium swallow is a quick and easy method for diagnosing oesophageal varices, there is considerable variation between observers because objective quantitative radiological criteria have so far not been defined. In order to define these criteria, a blind radiological/endoscopic comparative study using endoscopy as the gold standard was retrospectively carried out in 72 patients. A prospective study was then carried out in 47 patients to define the validity of the radiological criteria found by the first study. The results of both studies showed that the length and the width of the mucosal folds representing varices as measured on barium swallow radiographs have a significant relationship with the grade of the varices as determined by endoscopy. We conclude that barium swallow is a quick and reliable method for quantitative assessment of oesophageal varices.