Michael P. D'Alessandro, M.D.
Peer Review Status: Internally Peer Reviewed
Place the patient in a left lateral position.
Begin the exam by giving the patient barium by mouth. If the patient can adequately distend the esophagus in this manner, there is no need to place an NG tube in the patient.
If the patient cannot adequately distend the esophagus with barium taken by mouth, insert a nasogastric or 8 French feeding tube into the distal esophagus. Distend the esophagus with contrast, checking carefully for a fistula. If none is seen, pull the tube back a few centimeters and repeat, until you have reached the proximal esophagus.
Failure to demonstrate a tracheoesophageal fistula does not mean one does not exist. If the patient's symptoms persist, repeat the study in 1-2 months.
Views to Take:
AP and lateral views of the esophagus
See References Chapter.
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