Risks in X-ray examination of the oesophagus

X-ray examination of the oesophagus can lead to contact between the contrast medium and the lungs, connective tissue in the throat, and the mediastinum, pleura and peritoneum. The hyperosmolar iodine-containing contrast media used local irritation. Long-term changes have not been reported. Contrast media containing barium sulphate will hardly produce irritation but may lead to chronic foreign body irritation; they should not be used if they are likely to come into contact with the pleura and peritoneum. Both water-soluble iodine-containing contrast media and barium sulphate-containing contrast media have resulted in deaths due to pulmonary inundation. In case of suspected disturbance of swallowing or perforation, a water-soluble contrast medium should be used at first. If there are no abnormal conditions, examination can be continued with barium sulphate contrast media. The new isoosmolar water-soluble contrast media offer interesting possibilities of detail improvement. Their better tolerance with satisfactory imaging properties should be established by animal experiments and by clinical tests. (orig.)