Esophageal Flashcards

1
Q

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?

A

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

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2
Q

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?

A

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

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3
Q

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?

A

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

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4
Q

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?

A

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

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5
Q

Bongard JVECCS 2019
Which risk factors were found in this study regarding esophageal foreign bodies?

A

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

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6
Q

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?

A

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)

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7
Q

Brisson JAVMA 2018

Most common breed with EFB?

What was associated with Esophageal perforation?

Advancement into the stomach?

Incidence of esophageal stricture?

Mortality rate?

A

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%

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8
Q

Burton JVIM 2017

Most common Esophageal FB?

Most common location of Esophageal FB?

Incidence of esophageal stricture?

A

81% osseous foreign body

49.5% distal esophagus

Esophageal strictures in 2.1%

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9
Q

Nathanson JVIM 2019
-Esophagostomy tube complications

A

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

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10
Q

Reeve JSAP 2017
Flouro of esophagus in BOAS dogs

A

(44%) hiatal hernia
-all were Frenchies

(86%) delayed esophageal transit time

(75%) had gastro-esophageal reflux

(11%) had redundant esophagus

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11
Q

Risselada JAVMA 2018
Various gastrojejuostomy tube constructs
review

A

Injection and aspiration of all
~20F/8F
~24F/8F
~28F/8F
~28F/10F

5F only water

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12
Q

Smith JVECCS 2019
route and timing of nutrition for septic peritonitis cases

A

Dogs receiving PN only were less likely to survive than
those receiving any enteral nutrition

Maybe due to being sicker to begin with

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13
Q

Sterman JAVMA 2018
Perforations secondary to esophageal FB in dogs

A

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

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14
Q

Morams
Gastric carcinoma
VetSurg 2019

A

Major PO complications 20%
~septic 10%

Median Progression-Free Interval 54d

MST 178d

Intra-op complications = increased death ratio 3.5

Chemo improved survival

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15
Q

Duffy
Staple line gastrectomy
VetSurg 2021

A

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

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16
Q

O’Neill
GDV in dogs in UK ER
JSAP 2017

A

Prevalence 0.64%

Breeds with highest odds rations
~Great Dane 114x
~Akita 84x
~Dogue de Bordeaux 83 x

Odds increased with
~age up to 12 y
~Neutered male 1.3x female intact

Survival to discharge w/ Sx 79%

17
Q

Belch
Tube Gastropexy management of GDV
JSAP 2017

A

94% excellent short-term outcome
~GDV did not recur

10% major complications

84% were initially fed via the gastrostomy tube postoperatively

18
Q

White
Delay Sx GDV
JAVMA 2021

A

Delay Sx mortality 9%

Overall survival 88%
~immediate Sx 67%
~Delay Sx 91%

Time from presentation to surgery was not associated with
~surgeon subjective assessment of gastric health status
~mortality rate

Intra-op ID of gastric necrosis associated with nonsurvival.

Lactate associated with
~intraoperative gastric health status
~mortality rate.

19
Q

Broux
Manipulations to detect sliding hiatal hernia in BOAS
VetSurg 2018

A

Induced abnormalities
~manual pressure on the cranial abdomen
~Trendelenburg position
~Temporary complete endotracheal tube obstruction (may be the most accurate)

65% of dogs with BAOS presented with digestive clinical signs

20
Q

Conte
CT of Esophageal hiatus
VetSurg2020

A

Mean esophageal hiatus: aortic ratio
BOAS > Non-BOAS

Esophageal hiatus measurements weight-matched
BOAS > Non-BOAS

21
Q

Reeve
Hiatal hernia in brachycephalic with fluoroscopy
JSAP 2017

A

Hiatal hernia- all Frenchies
Delayed esophageal transit time (31/36)
Gastro-esophageal reflux (27/36)
Redundant esophagus (4/36)

22
Q

Grimes
Gastroesophageal intussusception
JAVMA 2020

A

88% survival to discharge with treatment

MST 995d

Clinical signs
~vomiting 67%
~Regurgitation 33%

Age 13.2 m
Male 72%
GSD 33%

70% persistent regurgitation associated with
< 7 days CS
Previous dx of megaesophagus

23
Q

Webb
Length and # sutures lines in a gastropexy
VetSurg 2019

A

Load to failure
2 cm < 4 cm

No difference in # sutures lines

24
Q

Grimes et al JAVMA 2020
What factors are associated with postoperative GER following gastroesophageal intussusception?

A

shorter duration of clinical signs
Previous diagnosis of megaesophagus

25
Q

Grimes et al JAVMA 2020
What was the rate of survival to discharge for dogs treated for gastroesophageal intussusception?

A

88%
65% long term survival

26
Q

Phillips et al JVIM 2019
What are the most common clinical signs for cats with hiatal hernias?

A

Vomiting
Weight loss
Anorexia

27
Q

Phillips et al JVIM 2019
Which had a better long term survival rate for cats with hiatal hernias - medial or surgical treatment?

A

Medical MST 2559 days
Surgical MST 771 days

28
Q

Abrams et al VetSurg 2019
What is the MST for canine gastric carcinoma?

A

178 days - longer with chemotherapy

29
Q

Sterman et al JAVMA 2018
What factors for associated with esophageal perforation with esophageal foreign body?

A
  • Fishhook foreign body
  • longer time to presentation
30
Q

Brisson et al JAVMA 2018
What factors were associated with a poorer prognosis after esophageal FB removal?

A

Duration of entrapment of FB
Presence of perforation

31
Q

Barash JVIM 2022

In outcomes of esophageal and gastric bone FB, esophageal erosion was associated with what factors?

A

Esophageal erosions were more likely with
-distal entrapment
-longer duration

Sixty-two of 84 bone gastric foreign bodies were left in situ.