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Small Animal Surgery > 4 - Esophagus > Flashcards

4 - Esophagus Flashcards

1
Q

What are the main indications for sx of the esophagus?

A

foreign bodies and esophageal feeding tubes

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2
Q

What are clinical signs associated with potential esophageal sx?

A

Regurgitation, dysphagia, ptyalism, altered appetite, coughing, dyspnea, fever, weight loss

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3
Q

What is regurgitation?

A

PASSIVE expulsion from esophagus

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4
Q

What is vomiting?

A

Centrally mediated reflux;

FORCEFUL expulsion from stomach or duodenum

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5
Q

What are the 3 approaches to esophageal sx?

A
  1. Cervical
  2. Thoracic
  3. Abdominal/transdiaphragmatic
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6
Q

Where does the thoracic esophagus get its blood supply?

A

Bronchoesophageal aa and segmental aortic branches

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7
Q

What are the 5 techniques that can be done on the esophagus?

A
  1. Esophagostomy
  2. Esophagectomy
  3. Esophagopexy
  4. Esophageal patching
  5. Esophageal substitution
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8
Q

What are the 4 layers of the esophagus?

A
  1. Mucosa
  2. Submucosa
  3. Muscularis
  4. Adventitia
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9
Q

What does the mucosa of the dog esophagus look like?

A

linear striations

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10
Q

What does the mucosa of the cat esophagus look like?

A

Distal portion = circular folds, herringbone pattern

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11
Q

What is the holding strength layer of the esophagus?

A

submucosa

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12
Q

The esophageal muscularis includes segmental _____.

A

blood supply

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13
Q

The esophagus has an adventitia instead of a _____. Because of this, the esophagus does not _____.

A

serosa, heal very well

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14
Q

What are 5 factors challenging healing of the esophagus?

A
  1. Segmental blood supply
  2. Lack of serosa and no omentum
  3. Constant motion and bolus distention
  4. Intolerance of longitudinal stretching/tension
  5. Passage of food and saliva
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15
Q

What layer should be incorporated in all sutures?

A

submucosa

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16
Q

What is an esophagotomy?

A

Incision into the esophageal lumen

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17
Q

What is an esophagectomy?

A

Partial resection of the esophagus

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18
Q

What is an esophagopexy?

A

Suture esophagus to another structure

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19
Q

What is esophageal patching?

A

Reinforce defect with muscle or other tissue

20
Q

What is esophageal substitution?

A

Replace esophagus with other tissue (skin tube or intestine)

21
Q

Up to ___% of the circumference can be debrided and edges apposed.

A

25%

22
Q

What side of the esophagus should be sutured first and why?

A

Far side because you don’t have access to both sides

23
Q

What side is the esophagus tacked to in an esophagopexy?

A

left

24
Q

What are 3 complications of esophageal surgery?

A
  1. Leakage
  2. Stricture formation
  3. Fistula formation
25
Q

What are the 8 special considerations related to surgery of the esophagus?

A
  1. Suspect concurrent aspiration pneumonia and esophagitis
  2. Perforations may be fatal
  3. Relatively fixed position; 3-5 cm resectable
  4. No serosa - slower sealing
  5. Segmental blood supply
  6. Constant motion: bolus passage and respiration
  7. 2-layer simple interrupted blosure, luminal knots
  8. No omentum
26
Q

What conditions call for esophageal surgery?

A

Foreign bodies, strictures, diverticula, paraesophageal abscess, tumors, hiatal hernia, cricopharyngeal achalasia, vascular ring anomalies

27
Q

What esophageal condition is not surgical?

A

Congenital/acquired megaesophagus

28
Q

Most esophageal foreign bodies can be removed _____. Surgical removal is indicated if _____ or _____.

A

endoscopically, perforated, can’t be safely dislodged

29
Q

What is an esophageal stricture and what are clinical signs?

A

Circumferential mucosal trauma;

Regurgitation +/- perforation

30
Q

What are the types of esophageal diverticula and how often do we see them?

A

Acquired or congenital (pulsion or traction);

They are rare

31
Q

How common are esophageal tumors and what type are they, usually?

A

They are rare and usually malignant

32
Q

What is the prognosis for an esophageal tumor once it is diagnosed?

A

guarded/poor because it is usually at an advanged stage at the time of diagnosis

33
Q

What is the most common cause of hiatal hernias and what breeds are likely to get them?

A

Most are congenital;

Brachycephalic breeds more prone - Sharpei, English bulldogs

34
Q

What are clinical signs of hiatal hernias?

A

Intermittent regurgitation, dysphagia, hypersalivation

35
Q

What is the prognosis for medical treatment of a hiatal hernia?

A

fair/good

36
Q

What is the prognosis for surgical treatment of a hiatal hernia?

A

fair/good

37
Q

What is gastroesophageal intussusception?

A

Invagination of the stomach and other organs into the esophagus

38
Q

What dogs commonly get gastroesophageal intussusception?

A

Young/large breed - EX: German Shepherd

39
Q

What 3 things can cause cricopharyngeal dysphagia?

A
  1. Achalasia
  2. Dyssynchrony
  3. Myasthenia gravis
40
Q

What is achalasia? What breeds are prone?

A

Failure of cricopharyngeus muscle to completely relax or open –> interruption of bolus passage from oropharynx to esophagus

Idiopathic hypertrophy of CP m.;

Mini-Dachshunds, Small breeds

41
Q

What is dyssynchrony? What breeds are prone?

A

Inappropriate bolus presentation to the UES;

Idiopathic - suspected neuropathy;

Golden Retrievers, Cocker Spaniels

42
Q

When can achalasia be diagnosed and why?

A

At weaning - switch from liquid to solid food

43
Q

What is the most common vascular ring anomaly and what can it lead to?

A

Persistent R aortic arch (95%);

Can lead to megaesophagus (cranial +/- caudal)

44
Q

What breed is most prone to vascular ring anomalies?

A

German Shepherds

45
Q

What should be ruled out if you suspect a vascular ring anomaly, especially in GSD?

A

Congenital megaesophagus

46
Q

What are indications for placement of an esophageal feeding tube?

A

Oropharyngeal disease/trauma, long term feeding

47
Q

What are contraindications for an esophageal feeding tube?

A

Esophageal disease

Small Animal Surgery (17 decks)

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