Question:
A barium swallow examination is shown below. What is the most probable diagnosis?
A barium swallow examination is shown below. What is the most probable diagnosis?
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Irregular narrowing with shouldered margins, not a smooth taper.
Updated On: Jun 23, 2026
- Esophageal carcinoma
- Esophageal ring
- Esophageal tear
- Achalasia cardia
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The Correct Option is A
Solution and Explanation
Answer: Esophageal carcinoma.
The barium swallow shows an irregular stricture with shouldered (overhanging) margins and mucosal destruction in the mid-oesophagus. This is the classic appearance of a proliferative squamous cell carcinoma.
Background: Squamous cell carcinoma and adenocarcinoma are the two commonest oesophageal cancers; SCC favours the mid-oesophagus.
Why not the others: An oesophageal ring (Schatzki) is a thin, smooth, web-like concentric narrowing at the gastro-oesophageal junction. An oesophageal tear shows contrast leak, not a stricture. Achalasia gives a smooth, tapering 'bird-beak' narrowing with a dilated proximal oesophagus, not an irregular shouldered stricture. Ref: Bailey & Love, Short Practice of Surgery, 27th ed, p. 1086
The barium swallow shows an irregular stricture with shouldered (overhanging) margins and mucosal destruction in the mid-oesophagus. This is the classic appearance of a proliferative squamous cell carcinoma.
Background: Squamous cell carcinoma and adenocarcinoma are the two commonest oesophageal cancers; SCC favours the mid-oesophagus.
Why not the others: An oesophageal ring (Schatzki) is a thin, smooth, web-like concentric narrowing at the gastro-oesophageal junction. An oesophageal tear shows contrast leak, not a stricture. Achalasia gives a smooth, tapering 'bird-beak' narrowing with a dilated proximal oesophagus, not an irregular shouldered stricture. Ref: Bailey & Love, Short Practice of Surgery, 27th ed, p. 1086
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