Esophageal Diseases Flashcards
What is the difference between the canine and feline esophagus?
Canines have striated mm. the entire length of the esophagus
Felines have smooth muscle in the distal portion
This is the outermost layer of the esophagus
Adventitia
The lower esophageal sphincter (LES) is also known as the
cardia
Vomiting or Regurgitation?
Abdominal contractions are present
Vomiting
Vomiting or Regurgitation?
Sphincters actively open and relax
Vomiting
What is the MOA of vomiting?
Reverse peristalsis from the stomach or duodenum
What is the MOA of regurgitation?
Backflow from the esphagus or pharynx
Vomiting or Regurgitation?
Which one is esophageal disease associated with?
REGURGITATION
If esophageal disease is suspected, what is the location
of the radiographs you would take?
Neck and thorax (with contrast)
When taking rads for suspected esophageal disease,
you’re evaluating for compressive lesions in these 2 locations
Intrathoracic
or
Cervical
The best method to evaluate peristalsis and swallowing
Fluoroscopy
Inflammation of the esophageal mucosa
Esophagitis
How is esophagitis diagnosed and what are the findings?
Endoscopy- erythemic and edematous mucosa
How is esophagitis treated?
Pain meds- Buprenorphine, Tramadol, Fentanyl Patch
Sucralfate or Carafate
Antacid (PPI- Omeprazole)
What are 3 risks associated with esophageal foreign bodies?
perforation
stricture
fistulae/diverticulae
If an esophageal foreign body is pushed into the stomach,
what medicine is contraindicated?
H2 blockers (Famotidine, Ranitidine, Cimetidine)
What is the tx for esophageal stricture?
Balloon dilation
an outpouching of mucosa through the muscular layer of the esophagus
is known as
Esophageal diverticulae
How is esophageal diverticulae diagnosed?
Rads or Fluoroscopy with contrast
The formation of esophageal diverticulae is secondary to
________ or congenital
trauma
Larger esophageal diverticulae are associated with
what 4 conditions?
impactions
esophagitis
rupture
pyothorax
Severe generalized dilation with
severely decreased or absent peristalsis of the esophagus
Megaesophagus
Thin linear soft tissue lines on a thoracic radiograph
is indicative of this esophageal condition
Megaesophagus
Congenital megaesophagus is due to
abnormal ________
neuromuscular innervation
What breeds are predisposed to congenital megaesophagus?
Sharpei, Fox Terrier, GSD, Labs, Danes, Irish Setters, Mini Schnauzers, Newfies
Siamese Cats
T/F:
Congenital megaesophagus may improve with time
TRUE
What are the causes of acquired megaesophagus?
Idiopathic
Primary CNS (brainstem lesion, Myasthenia Gravis)
Endocrine (Hypothyroid, Addison’s)
Lead Toxicity
What esophageal condition is associated with
lead toxicity?
Acquired Megaesophagus
What are some methods of treating megaesophagus?
Nutritional support (smaller frequent meals, thick-it, elevated food bowls) Feeding tubes
Treatment of the underlying disease
What is the prognosis for megaesophagus?
Fair to good when interventions work
Guarded to poor in MG crisis or aspiration pneumonia
A developmental abnormality in which an abnormal
vessel entraps the thoracic esophagus
Vascular ring anomaly
What is the most common vascular ring anomaly?
PRAA
persistent right aortic arch
T/F:
Vascular ring anomalies like PRAA are much more common in cats
FALSE!
More common in dogs
What breeds are predisposed
to vascular ring anomalies (like PRAA)?
Boston terrier, Irish setter, GSD
Persians, Siamese
A young irish setter presents with intermittent regurgitation,
unthriftiness, poor hair coat, and signs of aspiration pneumonia.
What is your primary ddx and what would you do to confirm?
Vascular ring anomaly (PRAA)
Imaging! Rads, Fluoroscopy, CT
What is the treatment for PRAA?
Surgical correction
Cystic nodules in the esophageal wall are seen
as dense masses on radiographs of a dog from Mississippi.
What is your primary ddx?
Spirocerca Lupi
T/F:
Fecal evaluation is a good way to diagnose spirocerca lupi infection
FALSE!
If there is no fistula allowing larva to pass into the alimentary tract,
S. lupi will not be detected in fecal! Use rads instead!
What is a complication seen sometimes in Hounds with
Spirocerca lupi infections?
Cyst→Granuloma→Sarcoma with Mets
This is a potentially fatal complication associated with
Spirocerca lupi infection
Aortic aneurysm (fatal bleeds)
A complication sometimes seen with Spirocerca lupi infections
includes hypertrophic osteopathy associated with neoplasia.
Exostosis can be seen on rads in this location
Between thoracic vertebrae
This intermediate host is necessary in the life cycle
of spirocerca lupi
Dung beetle
Spirocerca lupi larvae mature into adult worms in the _______
aorta
What preventatives are used in endemic regions
against spirocerca lupi?
Moxidectin/Imidacloprid
Spirocerca lupi is often too advanced to treat,
but can try these drugs
Doramectin
or
Ivermectin + Prednisolone
Which breeds are predisposed to esophageal hiatal hernias?
Sharpei, English bulldog, French bulldog
A Type 1 Esophageal Hiatal Hernia is also known as a
_______ hernia
sliding
What is the difference between a Type 1 and Type 2
Esophageal Hiatal Hernia?
In type 1 - LES and gastric fundus are displaced
In type 2- only the gastric fundus is displaced
T/F:
The best way to dx an esophageal hiatal hernia is endoscopy
FALSE!
Rads + Contrast + Fluoroscopy
T/F:
Neoplasia of the esophagus is very rare
TRUE
What are the 3 types of primary neoplasias that can occur in
the esophagus?
SCC
Leiomyosarcoma
Sarcoma
Which cancers can metastasize to the esophagus?
Thyroid
Mammary
Lymphoma
How is esophageal neoplasia diagnosed and what is the
prognosis?
Endoscopy and biopsy
VERY POOR PROGNOSIS with esophageal neoplasia :(
