Özofajit

Özet

Özofajit; reflü, enfeksiyon, ilaç, radyasyon veya başka mukozal hasarlara bağlı özofagus inflamasyonudur. Özofajit değerlendirmesinde baryumlu özofagografi ve endoskopi BT'den daha duyarlıdır; acil başvuruda göğüs BT'si çekilmişse özofagus bulguları da değerlendirilebilir. Özofajit değerlendirmesinde baryumlu özofagografi ve endoskopi BT'den daha duyarlıdır. Fokal veya asimetrik özofagus duvar kalınlaşması maligniteyle ilişkili olabilir; özofagus perforasyonu mediastinal ya da akciğer apsesiyle komplike olabilir.

Faz ve pencere

Venöz tanısal

Özofagus duvarı ve çevresindeki mediasten değerlendirilir; perforasyon veya fistül kuşkusunda periözofageal ya da mediastinal hava ve sıvı, ekstraluminal kontrast veya fistül traktı aranabilir.

BT bulguları

• Duvar kalınlaşmasına rağmen korunmuş, düzgün dış kontur ve özofagus çevresindeki yağ planlarının büyük ölçüde seçilmesi
• Özofagus lümeninde sıvı veya hava-sıvı düzeyi; eşlik eden dismotilite ya da daralma varsa proksimal genişleme
• Özofagus perforasyonunda periözofageal veya mediastinal hava ya da sıvı görülebilir; inflamatuvar değişiklikler komşu mediastinal dokuları etkileyebilir.
• Özofagus perforasyonu kuşkusunda fokal duvar defekti veya kalınlaşması, ekstraluminal kontrast, periözofageal ya da mediastinal hava veya sıvı ve mediastinal apse bulguları aranabilir.
• Perforasyon kuşkusunda, uygun klinik ve protokolle oral suda çözünen kontrast kullanılarak ekstraluminal kontrast kaçağı araştırılabilir; kaçak görülmemesi perforasyonu tek başına dışlamaz.

Normalde

BT'de normal özofagus duvar kalınlığı anatomik konuma, distansiyon derecesine ve cinsiyete göre değişir; dış duvar sınırları ve komşu yapılar normalde seçilebilir olmalıdır. Özofagus duvar kalınlığı anatomik konuma, distansiyon derecesine ve cinsiyete göre değiştiğinden kıyaslamayı benzer düzey ve distansiyonda yap; normalde dış duvar sınırları seçilebilir olmalıdır.

Ayırıcı tanı

Özofagus karsinomu

çoğu kez fokal veya asimetrik kalınlaşma, düzensiz lümen daralması ve infiltratif sınır gösterir.

Özofagus intramural hematomu

duvar içinde kan birikimine bağlı konsantrik veya eksantrik duvar kalınlaşması ve yüksek atenüasyonlu kitle görülebilir.

Özofagus dismotilitesi veya akalazya

akalazyada alt özofagus sfinkterinin gevşemesi bozulur; kronik gıda ve sekresyon retansiyonu özofagusta belirgin genişlemeye yol açabilir.

Radyasyon sonrası değişiklik

radyasyon özofagus inflamasyonuna ve özofajite yol açabilir.

Tuzaklar

• Özofagus incelemelerin çoğunda dekomprese olduğundan duvar kalınlığını distansiyon derecesini dikkate alarak değerlendir; normal kalınlık anatomik konuma, distansiyona ve cinsiyete göre değişebilir.
• Özofajit değerlendirmesinde baryumlu özofagografi ve endoskopi BT'den daha duyarlıdır.
• Fokal asimetrik kalınlaşma veya dış kontur düzensizliğini yalnız özofajitle açıklama; tümör olasılığını ayrıca değerlendir.

Kendini dene

1. Acil özofagus patolojilerinde BT hangi yöntemlerle birlikte kullanıldığında yararlı bilgi sağlar?

   • Baryumlu özofagografi ve endoskopi
   • Tek fazlı toraks BT ve Doppler ultrasonografi
   • Manyetik rezonans anjiyografi ve PET/BT
   • Akciğer grafisi ve transkraniyal doppler
   Cevabı göster

   Baryumlu özofagografi ve endoskopi. BT, acil özofagus patolojilerinde ilk başvurulan görüntüleme yöntemlerinden biri olabilir ve özofagografi ya da doğrudan görüntüleme ile birlikte kullanıldığında yararlı bilgi sağlar.

2. BT'de 13,5 mm'nin üzerindeki asimetrik özofagus duvar kalınlaşması hangi olasılık açısından anlamlı bulunmuştur?

   • Malignite
   • Akalazya
   • Dismotilite
   • Perforasyon
   Cevabı göster

   Malignite. Çalışmada, BT'de 13,5 mm'yi aşan asimetrik özofagus duvar kalınlaşması malignite açısından anlamlı bulunmuştur; bu bulgu tek başına tanı koydurmaz.

Kaynaklar

Bu sayfadaki 29 cümle ve 2 quiz sorusu aşağıdaki kaynaklardan alıntılarla otomatik olarak karşılaştırıldı; 23 cümle bu karşılaştırmada düzeltildi (2026-10-09).

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Eğitim amaçlıdır; hasta başında tanı ve tedavi kararının yerine geçmez, tıbbi tavsiye değildir. Metinler yapay zekâ desteğiyle yazıldı ve otomatik bir adımda kaynak alıntılarıyla karşılaştırıldı; bu bir tıbbi doğrulama değildir ve içerik uzman radyolog incelemesinden geçmedi. Klinik kararlarda güncel kılavuzları, kurum protokollerini ve radyoloji raporunu esas alın.