Imaging Of The Pharynx And Esophagus – Giovanni Fontanella (1)

Figure 5.32 Arteria lusoria. Typical Fluoroscopic Results Aneurysms in the transverse arch of the aorta and the descending portion of the thoracic aorta bulg- ing posteriorly may result in extensive erosion of the anterior surfaces of the adjacent vertebral bod- ies (Oppenheimer’s sign). Other less commonly encountered causes of aneurysms of the thoracic aorta exist.

Poststenotic aneurysms are usually congenital, being associated with coarctation of the aorta. Mycotic or other infective aneurysms are usually small and are associated with a localized aortitis. Post-traumatic aneurysms often occur in the area of the left subclavian artery. Such aneu- rysms often calcify in later stages.

A hematoma at the site of trauma may simulate an aneurysm on occasion. Dissecting aneurysms may compress or displace the esophagus. The tear in the wall of the aorta in dissections most commonly occurs in the ascending aorta, often extending down into the abdominal aorta. The tear in a dissecting aneurysm may communicate with the pericardial sac, the pleural cavity, or the mediastinum.

5.4.17 Aortitis The aorta is typically dilated, adhesions form between the esophagus and aorta, fixing the adjacent area of the esophagus to the aorta, and irregular indentations along the esophagus below the level of the aortic arch. Aortitis is caused by a number of diseases, such as syphilis, rheumatic fever, sep- ticemia, scarlet fever, and meningitis. 5.4.18 Pleural Effusion Depending on the location and volume of fluid, the opacified esophagus in pleural effusion may be moved to the left or right.

5.4.19 Pleural Adhesions The upper thoracic esophageal segment (and trachea) is typically pulled to the right by fibrotic bands in pleuropulmonary adhesions, particularly from chronic pulmonary tuberculosis. This fre- quently results in a sharp angulation and, on occasion, even serrated irregularities of the lateral border of the adjacent esophageal segment. If the lower esophageal segment is on the left side, pleu- ral adhesions and organized pleural effusions may affect it, preventing normal distensibility and Figure 5.33 Arteria lusoria.

Often neglected or wrongfully discarded as obsolete, barium swallows are still a staple of the daily routine of radiology departments worldwide, serving as an important tool to support the clinical and endoscopic diagnosis of the upper gastrointestinal tract. Like other imaging methods, barium radiography and fluoroscopy have also undergone radical technological changes and upgrades.

This book constitutes a seminal volume on the subject, easily accessible to junior graduate students and specialists, showcasing that before being a diagnostic tool of utmost importance, it is a form of art worth preserving and passing on to future generations. Covering sections such as oral and pharyngeal anatomy and an overview of clinical disorders, the basics of pharyngoesophageal endoscopy, CT, and MR imaging, as well as the art of interpreting the images, this book provides an extensive and well-illustrated guide to the morphodynamic imaging of the pharynx and esophagus.

Key Features ◾Underscores the value of the barium swallow study in the evaluation of the upper gastrointestinal tract in both routine and complex diagnostic scenarios ◾Illustrates the technological advancements in imaging, such as radiographic and fluoroscopic techniques supplemented by digital imaging and improved contrast media ◾Caters to both early career learners and experienced clinicians and offers a structured exploration of anatomy, pathology, and radiologic techniques Imaging of the Pharynx and the Esophagus Giovanni Fontanella MD FRSA MBSImPc Designed cover image: Giovanni Fontanella First edition published 2026 by CRC Press 2385 NW Executive Center Drive, Suite 320, Boca Raton, FL 33431 and by CRC Press 4 Park Square, Milton Park, Abingdon, Oxon, OX14 4RN CRC Press is an imprint of Taylor & Francis Group, LLC © 2026 Giovanni Fontanella This book contains information obtained from authentic and highly regarded sources.

While all reasonable efforts have been made to publish reliable data and information, neither the author[s] nor the publisher can accept any legal responsibility or liability for any errors or omissions that may be made. The publishers wish to make clear that any views or opinions expressed in this book by individual editors, authors or contributors are personal to them and do not necessarily reflect the views/opinions of the publishers. The information or guidance contained in this book is intended for use by medical, scientific or health-care professionals and is provided strictly as a supplement to the medical or other professional’s own judgement, their knowledge of the patient’s medical history, relevant manufacturer’s instructions and the appropriate best practice guidelines.

Because of the rapid advances in medical science, any information or advice on dosages, procedures or diagnoses should be independently ­verified.

This is a short excerpt from the opening of “” by Unknown, quoted for review and introduction purposes. All rights belong to the copyright holders.

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