Normal indentations on the esophagus in barium swallow – Right anterior oblique view chest X-ray

Barium swallow – Right anterior oblique view chest x-ray – showing normal indentations of oesophagus

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• The normal indentations of the esophagus seen in a right anterior oblique view during barium swallow are made by (from above downwards):
  • Aortic arch – 22.5 cm from incisor teeth
  • Left bronchus – 27.5 cm from incisor teeth
  • Left atrium
• Clinical importance:
  • In olden days, when echocardiography was not available, this was used to detect left atrial enlargement in cases of mitral stenosis
  • When left atrium is enlarged, it may compress on the esophagus and cause dysphagia – known as cardio esophageal syndrome