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Extra info for Advanced Imaging of the Abdomen
Sample text
A barium esophagram reveals an intramural tumor. The appearance is similar to that of a small leiomyoma. Endoscopic US shows a hypoechoic, solid, intramural tumor (90). Magnetic resonance imaging in a patient with progressive dysphagia revealed a granular cell tumor to be hypointense on T1-weighted images and mildly hyperintense on T2-weighted images (91); homogeneous contrast enhancement was evident. Carcinoids Esophageal carcinoids are rare. The literature is somewhat vague when describing these tumors and such terms as atypical carcinoids and esophageal endocrinomas are encountered, with the latter term used to describe a number of endocrine-active tumors.
36 ADVANCED IMAGING OF THE ABDOMEN Plummer-Vinson Syndrome A combination of dysphagia, esophageal webs, and iron-deficiency anemia is characterized as the Plummer-Vinson syndrome. Patients are at increased risk of developing a postcricoid carcinoma. As already mentioned, these webs are readily dilated. Epidermolysis Bullosa Epidermolysis bullosa, an inherited autosomalrecessive autoimmune disorder, is characterized by bullous lesions of the skin and bullae, erosions, and ulcerations in the oropharynx and esophagus.
Anatomic and functional abnormalities are common even in young adults. In patients younger than 30 years with dysphagia, a barium esophagram was able to explain symptoms in 70% (94); findings included achalasia, dysphagia lusoria, esophagitis, esophageal dysfunction, stricture, gastroesophageal reflux, and pharyngeal dysfunction. A number of dysmotility findings are specific for a particular disorder but some cannot be pigeonholed into a specific category; these are often given such terms as nonspecific esophageal motility disorder or lower esophageal sphincter 37 ESOPHAGUS dysfunction.
