Tuesday, 30 November 2010

Appearance of lye strictures in X-ray


-What is the most likely diagnosis in the patient shown below?

a. Esophageal varices
b. Esophageal carcinoma
c. Reflux esophagitis
d. Lye stricture
e. Fibrovascular polyp


THE RIGHT ANSEWR :
.d

There is very long segment of smoothly narrowed esophagus from just below the level of the clavicles to the EG junction. This appearance is characteristic of a stricture caused by the ingestion of a caustic material such as lye. Lye, which became component of some drain cleaners in the late ?60s, is so highly toxic that only a few drops can cause this full-thickness liquefaction necrosis of the esophagus. The acute ulcerative phase is invariably followed in several weeks by this fibrotic stage. There is a significantly higher incidence of carcinoma of the esophagus in patients with lye strictures than in the normal population.

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