02 - esophagus and disorders of swallowing Flashcards
(oropharyngeal dysphagia)
- oral dysphagia = ?
- pharyngel dysphaga = difficulty with transport of bolus where?
- difficulty with prehension or transport of food to pharynx
- from oropharynx through the cranial esophageal sphincter
(oropharyngeal dysphagia)
Cx
- oral dysphagia?
- pharyngeal dysphagia?
- abnormal prehension/mastication
- unsuccesful swalloing (gagging, retching), aspiration pneumonia common
causes of regurg?
megaesophagus, muscle weakness, neuro deficits
(imaging)
- what is required for diagnosis of functional abnormalities?
- fluoroscopy with a barium swallow
(esophageal hypomotility)
- may be segmental or diffuse, congenital or acquired
- most common cause of megaesophagus in dogs?
- acquired megaesophagus may occur secondary to diseases causing what?
- idiopathic
- diffuse neuromuscular dysfx
(esophageal hypomotility)
- primary Cx?
- dyspnea, cough, and fever suggest what?
- regurg
- aspiration pneumonia
(esophageal hypomotility)
(megaesophagus)
- dx?
- congenital disorders suggested when signs first noticed when?
- what kind of dogs?
- exclusion
- at the time of weaning
- larger dogs (+siamese cat)
(esophageal hypomotility)
(megaesophagus)
- may be unremarkable except for what?
- lab test to test for what?
- weight loss
- acetylcholine receptor antibody titer to test for acquired myasthenia gravis
(esophageal hypomotility)
(megaesophagus)
- tx?
- usually symptomatic and supportive - frequent small meals in upright position (liquid food)
is idiopathic megaesophagus usually reversible?
no
(esophageal FB)
- lodge what 3 places?
- complications?
- thoracic inlet, base of heart, hiatus of diaphragm
- esophagitis, perf, stricture,
(esophageal FB)
- dx usually confirmed by what?
- radiography, barium contrast esophageal radiography, or esophagoscopy
(check for aspiration pneumonia - pneumomediastinum, pneumothorax, mediastinal or pleural effusion suggest esophageal perf)
(esophageal FB)
- tx?
- endoscopic removal best (if can’t get out mouth push into stomach to remove by gastronomy)
if neither of these work esophagotomy indicated
(esophageal perforation)
- most common cause?
- Cx?
- foreign bodies
- anorexia, depression, odynophagia, and a rigid stance
(esophageal perforation)
- radiographs show what?
- CBC shows what?
- pneumomediastinum, pneumothorax, and mediastinal or pleural effusion
- neutrophilia with left shift
(esophageal perforation)
- tx for small tears?
- for large?
- medical mgmt: abx, fluids, no feeding for a week
- sx
(esophagitis)
- 4 causes?
- infection that causes?
- FB, oral meds (doxycycline), thermal/caustic injury, reflux
- pynthium insodium
(esophagitis)
- what is the most sensitive method of diagnosis?
- esophagoscopy
(esophagitis)
- general tx?
- for reflux?
- abx and frequent feedings of small portions of soft food
- promotility agents (metoclopramide), H2 blockers, sucralfate, prednisolone
(esophageal stricture)
- may result from what?
- radiographs may show what proximal to the stricture?
- most common tx?
- severe esophagitis or esophageal sx
- distension (contrast studies or endoscopy may be helpful in the dx)
- balloon catheter dilation (prednisolone to prevent further fibrosis and stricture)
(esophageal diverticula)
- what are these?
- tx for small?
for large?
- pouchlike sacculations of the esophageal wall and may be congenital or acquired (may become impacted -> esophagitis)
- freq small meals of soft food
- surgical resection
(esophageal fistula)
- communication between esophagus and what?
- acquired or congenital more common?
- Cx signs (coughing, fever, dyspnea) result from what?
- airways (bronchi most common)
- acquired (FB, trauma, malignancy, infection)
- contamination of airways with fluid and food
(vascular ring anomalies)
- most common?
- what happens?
- PRAA (95%)
- right rather than the left fourth aortic arch is retained -> compression of the esophagus between the ligamentum arteriosum, the aorta, the pulmonary trunk, and base of the heart
(vascular ring anomalies)
- Cx
- regurg at time of weaning, no weight gain, cough and dyspnea
(vascular ring anomalies)
- radio finding2?
- esophageal dilation cranial to the heart, absence of normal bulge of aortic arch, leftward tracheal deviation cranial to the heart
(vascular ring anomalies)
- treatment?
- sx ligation
(hiatal disorders)
- hiatal hernia = ?
- gastroesophageal intussusception = ?
- protrusion of the distal esophagus and stomach through esophageal hiatus
- invagination of the stomach into the distal esophagus (seen with congenital idiopathic megaesophagus)
Cx signs of small hiatal hernias are due primarily to what?
Cx signs for large displacements?
reflux esophagitis
signs of obstruction (dyspnea, hematemesis, collapse, rapid deterioration, death)
tx for large hernias?
for small?
surgery
medical (tx for reflux and small food portions)
(periesophageal obstruction)
- what is this?
- Cx include what?
- extraluminal compression can be caused by cervical or mediastinal masses
- regurgitation, dysphagia, hypersalivation
(esophgeal neoplasia)
- how common is primary neoplasia?
- most common in dogs? cats?
- osteosarc and fibrosarc may develop with malignant transformation of a granuloma cause by what?
- endoscopy and biopsy required for definitive dx, surgical excision is required
- rare
- leiomyoma, SCC
- spirocerca lupi
