Esophageal Flashcards
Sterman, JAVMA, 2018:
Esophageal perforation secondary to esophageal foreign body
What % of dogs had esophageal perforation?
What was associated with increased likelihood of esophageal perforation?
What % of esophageal perforations were diagnosed on routine thoracic radiographs?
What % of esophageal perforations did not require surgical intervention?
Sterman, JAVMA, 2018:
12% had esophageal perforations
Delay in seeking veterinary attention increased the likelihood of esophageal perforation
27% of esophageal perforations were diagnosed on routine thoracic radiographs
60% of esophageal perforations did not require surgical intervention, suggesting rapid sealing of esophageal defects
Brisson, JAVMA, 2018:
Esophageal foreign bodies
Most common esophageal foreign body?
Most common location of esophageal foreign bodies?
Most common location of fish hook foreign bodies vs bone foreign bodies?
Factors associated with a poor outcome?
What % developed esophageal strictures?
Brisson, JAVMA, 2018:
Most common esophageal FB was bone (60% of cases)
Most common location of esophageal FBs was caudal esophagus (58% of cases), followed by the heart base (23% of cases)
Most common location for fish hook FBs was cervical esophagus, most common location for bone FBs was caudal esophagus
Factors associated with a poor outcome: longer duration of FB entrapment, esophageal perforation, older age
11% developed esophageal strictures
Bongard, JVECC, 2019:
Esophageal foreign bodies
Overall success rate for foreign body removal via esophagoscopy?
Complication rate?
Dogs with foreign bodies present for >24 hours were more likely to have what?
What type of foreign body was more likely to require surgical removal?
Bongard, JVECC, 2019:
Overall success rate for FB removal via esophagoscopy: 95%
Complication rate: 22%
Dogs with foreign bodies present for >24 hours were more likely to have severe esophagitis and major complications
Fish hooks were more likely to require surgical removal
Nathanson, JVIM, 2019:
Complications associated with esophageal feeding tubes
Overall complication rate?
What % of cats vs dogs developed signs of infection at the tube site?
What % of cats vs dogs developed regurgitation of food through the tube stoma?
Nathanson, JVIM, 2019:
44% complication rate
18% of cats vs 14% of dogs developed signs of infection at the tube site
1% of cats vs 7% of dogs developed regurgitation of food through the tube stoma
Bongard JVECCS 2019
Which risk factors were found in this study regarding esophageal foreign bodies?
Small breed dogs were overrepresented (Yorkies, WHWT, Shih Tzu)
Dogs w/ FB present for more than 24 hours were significantly more likely to have severe esophagitis and major complications
FB type did not predict degree of esophagitis or complications, though fishhooks were more likely to require surgery and more likely located in cervical esophagus/thoracic inlet
FB more commonly lodged in distal esophagus
Feeding tubes (15 gastrostomy, 1 NE) were placed in 14% of dogs are more likely placed if FB had been present for more than 24 hours
Overall success rate for removal via scope was 95% and complication rate 22%
78% survival rate with no complications
Binvel JSAP 2018
What was found in this study in regards to endoscopic retrieval of esophageal/ gastric FB?
Most common location?
Endoscopy successful in?
Esophageal perforation in?
Surgery?
Breeds?
Most common location:
-prox esophagus (36%)
-stomach (33%)
Endoscopic retrieval was successful in 82% of cases
Esophageal perforation occurred in 18% of cases
Surgery performed in 18% of cases and no early complications were noted
Survival rate was 100% overall
No breed predisposition (other studies describe a high % in small breeds- terrier and poodles)
Brisson JAVMA 2018
Most common breed with EFB?
What was associated with Esophageal perforation?
Advancement into the stomach?
Incidence of esophageal stricture?
Mortality rate?
Terrier breeds most common (30.5% of 233 dogs)
Associated with esophageal perforation?
-Duration of EFB entrapment
-body wt
-anorexia
-lethargy
-rectal temp
Endoscopy or advancement into stomach was a success in 83.6% EFBs
11.2% resulted in postprocedural esophageal stricture
Mortality rate was 5.4%
Burton JVIM 2017
Most common Esophageal FB?
Most common location of Esophageal FB?
Incidence of esophageal stricture?
81% osseous foreign body
49.5% distal esophagus
Esophageal strictures in 2.1%
Nathanson JVIM 2019
-Esophagostomy tube complications
No statistically sig risk factors found
Overall complications 44.4%
dogs (43.1%)
cats (45.5%)
Infection
cats (17.8%)
dogs (13.7%)
Regurgitation of food through the E-tube stoma was
noted in 7 dogs and 1 cat.
Three patients were euthanized as a result of tube-related complications
Reeve JSAP 2017
Flouro of esophagus in BOAS dogs
(44%) hiatal hernia
-all were Frenchies
(86%) delayed esophageal transit time
(75%) had gastro-esophageal reflux
(11%) had redundant esophagus
Risselada JAVMA 2018
Various gastrojejuostomy tube constructs
review
Injection and aspiration of all
~20F/8F
~24F/8F
~28F/8F
~28F/10F
5F only water
Smith JVECCS 2019
route and timing of nutrition for septic peritonitis cases
Dogs receiving PN only were less likely to survive than
those receiving any enteral nutrition
Maybe due to being sicker to begin with
Sterman JAVMA 2018
Perforations secondary to esophageal FB in dogs
Common EFB
-Bones [44%]
-Fishhooks [30%]
Esophageal perforation:
12%
Associated with:
-fishhook EFB [27%]
-time to presentation
Esophageal perf survival to discharge:
87%
8 of 15 esophageal perforation required no surgical intervention
Morams
Gastric carcinoma
VetSurg 2019
Major PO complications 20%
~septic 10%
Median Progression-Free Interval 54d
MST 178d
Intra-op complications = increased death ratio 3.5
Chemo improved survival
Duffy
Staple line gastrectomy
VetSurg 2021
Placement of Cushing’s
~increased initial leakage pressure 3.2x
~increased max leakage pressure 2.8x
*over stapled only
Double layer suture
~increased initial leakage pressure 4.5x
~increased max leakage pressure 3x
*over stapled only
