Relative sensitivity of barium swallow examination in the diagnosis of oesophageal pathology.

Dysphagia is a common reason for radiographic examination of the oesophagus to assess structural or functional abnormalities. From February 1, 1989 to August 28, 1993, six hundred and sixty eight patients had barium swallow examination. Out of 668 patients complaining of dysphagia, 173 patients had either histologically confirmed diagnoses and/or surgical diagnoses or oesophagoscopic diagnoses. The histological, oesophagoscopic and surgical diagnoses were: malignant tumours of the oesophagus 137 patients, achalasia of the cardia 21 patients, diverticula of the oesophagus six patients, peptic structures, five patients and non specific oesophagitis, four patients. Barium swallow agreed with 166 (96%) histological, oesophagoscopic and surgical diagnoses. The Kappa statistic was high (> .8). The mean age for patients with malignant tumours of the oesophagus was 53.5 years (range: 32-75 years), and for achalasia of the cardia was 36 years (range: 14-58 years). Patients with malignancy are in higher age group categories in comparison to the non-malignant patients (OR = 0.07 (0.02, 0.17). The mean duration of dysphagia for achalasia of the cardia was 8.5 years. The major cause of dysphagia was found to be malignant tumour of the oesophagus. Further study is recommended to determine the pattern of oesophageal pathologies to substantiate the finding.