What is the role of esophageal barium study (esophagography) in the diagnosis of cytomegalovirus (CMV) esophagitis?

Updated: May 02, 2019
  • Author: Deepika Devuni, MBBS; Chief Editor: BS Anand, MD  more...
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On double-contrast esophagrams, cytomegalovirus (CMV) esophagitis is typically manifested by one or more giant and relatively flat ulcers, sometimes associated with small satellite ulcers (see the image below).

Infectious esophagitis. Cytomegalovirus esophagiti Infectious esophagitis. Cytomegalovirus esophagitis in a patient with acquired immunodeficiency syndrome (AIDS). Double-contrast esophagram shows a large, flat ulcer in profile (large arrows) in the mid esophagus with a cluster of small satellite ulcers (small arrows). Because HIV esophagitis may produce identical radiographic findings, endoscopy is required to confirm the presence of cytomegalovirus before patients are treated.

These ulcers may be ovoid, elongated, or diamond shaped, and they are frequently surrounded by a radiolucent rim of edematous mucosa. Less commonly, CMV esophagitis appears as small superficial ulcers that are indistinguishable from the ulcers of herpes esophagitis on barium studies.

See Cytomegalovirus Esophagitis for complete information on this topic.

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