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E1181. CT Esophagram: A Case-Based Review of Parameters and Pathologies
Authors
  1. Ashley Norton-Gregory; Medical College of Wisconsin
  2. Rajeev Mannem; Medical College of Wisconsin
  3. Stephane Desouches; Medical College of Wisconsin
Background
Esophageal injuries require prompt diagnosis and treatment as the mortality of esophageal perforation approaches 20%. Imaging plays an integral role in obtaining a timely diagnosis with fluoroscopic esophagram the most common modality when evaluating for esophageal perforation. However, CT esophagram is an important alternative allowing for 24/7 accessibility, as it does not require an on-call fluoroscopy team and can be performed without a radiologist on site.

Educational Goals / Teaching Points
This educational exhibit will discuss imaging techniques and highlight important pathologies for CT esophagram using an image-rich, case based approach. After completion of the exhibit, readers will understand the applications and utility of CT esophagram as well as commonly encountered pathology.

Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
When used in the proper clinical setting, CT esophagram provides a more consistent and accessible imaging method for evaluating esophageal injuries, including postoperative leaks, trauma, perforation, and iatrogenic injury. CT esophagram also provides additional benefits beyond fluoroscopy such as the ability to diagnose non-esophageal etiologies of symptoms such as vascular injury, PE, abdominal pathology, and incidental findings such as malignancy.

Conclusion
Although CT esophagram is a fairly novel imaging technique, it has an important role in the workup of esophageal pathology; providing an accurate diagnosis even at hospital sites without a radiologist on site.