Preliminary Diagnosis: Gastroesophageal Reflux Disease (GERD)
I. What imaging technique is first-line for this diagnosis?
Fluoroscopic guided double contrasted upper GI examination using effervescent granules, thick liquid barium, and a barium pill
II. Describe the advantages and disadvantages of this technique for diagnosis of GERD.
Advantages
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Highly portable and quick procedure
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Adept in localizing ulcerations, strictures, webs, stenosis, extravasation, or other complications from reflux disease
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Gold standard in evaluating for gastroesophageal reflux disease
Disadvantages
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Highly operator dependent
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Exposes patients to ionizing radiation
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Less adept in detailing the surrounding soft tissue and osseous structures
III. What are the contraindications for the first-line imaging technique?
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May be contraindicated in pregnant patients
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May be contraindicated in patients unable to take PO contrast; alternatively, contrast may be administered via NG tube
IV. What alternative imaging techniques are available?
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CT evaluation of the abdomen with PO contrast
V. Describe the advantages and disadvantages of the alternative techniques for diagnosis of GERD.
CT evaluation of the abdomen with PO contrast
Advantages
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Offers exquisite detail of the surrounding soft tissue, vascular, and osseous structures
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Better evaluates for any secondary complications than other imaging modalities
Disadvantages
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Less portable
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Does not allow a dynamic evaluation of the gastroesophageal motility
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Exposure to ionizing radiation
VI. What are the contraindications for the alternative imaging techniques?
CT evaluation of the abdomen with PO contrast
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May be contraindicated in pregnant patients
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