Which is the investigation of choice in a case of stricture esophagus caused by corrosive poisoning ?
**Core Concept**
Esophageal stricture caused by corrosive poisoning is a condition where the esophagus becomes narrowed due to scarring and fibrosis following chemical injury. This condition can lead to dysphagia, food impaction, and potentially life-threatening complications.
**Why the Correct Answer is Right**
The investigation of choice in such cases is **barium swallow study (or esophagram)**, which is a radiographic imaging technique that uses a barium sulfate contrast agent to visualize the esophagus. This study helps to assess the severity and extent of the stricture, as well as any associated complications such as esophageal perforation or mediastinitis. The barium swallow study is particularly useful in this scenario as it can provide a detailed view of the esophageal lumen and any narrowing or irregularities.
**Why Each Wrong Option is Incorrect**
* **Option A:** Endoscopy is not the primary investigation of choice for stricture esophagus caused by corrosive poisoning, although it may be used in some cases to assess the severity of the stricture or to perform dilatation.
* **Option B:** CT scan may be used to evaluate complications such as mediastinitis or abscess formation, but it is not the primary investigation for assessing the stricture itself.
* **Option C:** Manometry is a diagnostic tool used to assess esophageal motility disorders, not stricture esophagus.
**Clinical Pearl / High-Yield Fact**
In cases of corrosive poisoning, it is essential to manage the patient promptly and aggressively to prevent complications. Early endoscopic evaluation and dilatation may be necessary to prevent stricture formation.
**Correct Answer: C. CT scan may be used to evaluate complications such as mediastinitis or abscess formation, but it is not the primary investigation for assessing the stricture itself.