Esophagus Flashcards
What media should you use if esophageal perforation is suspected
idoinated media
What are indications for radiographing the esophagus
dysphagia
regurgitation
gagging
retching
diagnose and evaluate for esophageal form and function
foreign bodies
strictures
vascular ring anomalies
dysmotility
What is contraindiciated if perforation is suspect or heading to endoscopy?
Barium
What can cause pulmonary edema is aspirated
Iodinated Media- use non-ionic
What is more opaque: barium or iodinated media
Barium
T/F: megaesophagus is a clinical diagnosis
False
persistently dilated and hypomotile esophagus from neurologic dysfunction
Megaesophagus
What do you need to differentiate megaesophagus from
transient aerophagia
use clinical signs and radiographs (different time points) to help differentiate
What are the radiographic findings of megaesophagus
1) Tracheal stripe sign
-soft tissue margin between luminal gas of trachea and air within the esophagus
-silhouette sign of combined thickness of the tracheal and esophageal walls
2) Esophagus more visible
3) V sign on VD radiograph
4) Food- granular soft tissue/gas/mixture may be seen with a dilated esophagus
-widened mediastinum
-displacing tracjea vemtra;;y
5) Secondary aspiration pneumonia: alveolar pattern
What might cause congenital megaesphagus in dog
1) Idiopathic juvenille mesesophagus (generalized) - german shephards, great danes, irish setters
2) Vascular Ring Anomalies (focal megaesophagus)
-Persistent Right Aortic Arch
-Aberrant left subclavian arteryu
-Double Aortic Arch
Vascular Ring anomalies cause focal or generalized megaesophagus
Focal
Idiopathic juvenille mesesophagus (generalized occurs in what breeds
german shephards
great danes
irish setters
What might cause acquired megaesophagus in dogs
Myasthenia gravis
Paraneoplastic
Addisons
Lead toxicity
Polymyositis
CNS disease
Chest trauma
Tetanus
Autoimmune
Obstructions due to foreign bodies, strictures
What might cause megaesophagus in cats
Vascular Ring Anomalies
Esophageal Strictures from esophagitis- Doxycycline
Idiopathic
failure of regression of duplicate parts of embryonic arch system during cardiovascular development
Vascular Ring Anomlaies
What are the types of vascular ring anomalies
-Persistent Right Aortic Arch
-Aberrant left subclavian arteryu
-Double Aortic Arch
Where the esophagus becomes trapped by the heart, PRAA, main pulmonary artery and ligamentum arteriosum
Persistent Right Aortic Arch
Persistent Right Aortic Arch causes
focal narrowing of the esophagus with dilation cranially
may also be dilated caudally
How do you treat Persistent Right Aortic Arch
surgical repair
What is a key finding of persistent right aortic arch
focal left-ward deviation of the trachea
What are common sites in the esophagus for foreign bodies
thoracic inlet
heart + base
esophageal hiatus
What are complications of esophageal foreign bodies
Stricture
Perforation + Periesophageal abscess
Pneumomediastinum / Pneumothorax
Pleural effusion
With esopheageal foreign bodies, there is often gas ______ to the foreign body
cranial
Is the prognosis of cervical or thoracic perforation better
Cervical
thoracic often lead to septic mediastinitis, pleuritis, pyothorax
gastric acid that enters the esophagus from gastroesophageal reflux results in
esophagitis
rads often normal and possibly increased soft tissue opacitiy between aorta and vena cava on both lateral projections
esophagitis radiographic findings
rads often normal and possibly increased soft tissue opacitiy between aorta and vena cava on both lateral projections
with increased severity, caudal esophagus may become enlarged and contain air or fluid
What breeds commonly get redundant esophagus
english bulldogs
What might cause esophageal strictures
Esophageal trauma or inflammation
Reflux of gastric contents during anesthesia
What are the findings of esophageal structures
rads often normal
esophagram can aid diagnosis- liquid barium, barium mixed w food
Definitive dx w endoscopy
What are the 3 phases of esophagram
1) Liquid Barium
2) Barium/canned food
3) Barium/dry food
