Esophagus and Stomach

Question 1

What are the the types of contrast agents?

Answer 1

Positive: barium and iodine
Negative: air

Question 2

What are the 2 types of iodine contrast agents

Answer 2

Non-ionic: safer (use if might be absorbed)
Ionic

Question 3

Barium sulphate

Answer 3

Insoluble in water
Not absorbed by patient
Only used in the GI tract

Question 4

Why use barium over iodinated contrast agents

Answer 4

Coats the mucosa well
Adheres to inflamed tissue in the GI tract
Iodinated is hyperosmolar: stimulate fluids to enter GI (dehydration)

Question 5

Benefits of iodinated contrast agents

Answer 5

If it leaks out of the GI tract, won’t cause problems

Question 6

When are ionic contrast agents use?

Answer 6

Joint infusion studies

Question 7

What should you do before performing contrast studies of the esophagus?

Answer 7

Plain/survey rads
only follow up with contrast studies if unsure of dx

Question 8

Contrast studies for the esophagus

Answer 8

Admin barium orally then immediately get lateral and VD/DV of neck and thorax
Gets rads while feeding patient barium in lateral

Question 9

What’s another way to get contrast studies for the esophagus?

Answer 9

Barium food bolus
Helps visualize stricture or defect in esophagus (food won’t pass through defect)

Question 10

Redundant esophagus / Hypermotile esophagus

Answer 10

@ the thoracic inlet food doesn’t get propelled to the cd. esophagus quickly and contrast pools
In Shar-peis

Question 11

Cricopharyngeal Achalasia

Answer 11

Dyssynchrony between the contraction of the pharynx and the movement of the tongue
Food doesn’t get propelled into the cd. esophagus as it should

Question 12

What are patients with cricopharyngeal achalasia predisposed to?

Answer 12

Aspiration pneumonia

Question 13

Dx and tx for cricopharyngeal achalasia

Answer 13

Contrast study and fluoroscopy
Sx cut cricopharyngeal m.

Question 14

Megaesophagus

Answer 14

Focal (prevents movement of food from oral cavity to stomach) or diffuse

Question 15

Consequences of megaesophagus

Answer 15

Ability to swallow impaired
Aspiration pneumonia

Question 16

What’s the most common vascular ring anomaly

Answer 16

Persistent right aortic arch (classic finding: regurg after switching from milk to solid food)

Question 17

Esophageal FB/ Trauma

Answer 17

Ingested something too big and doesn’t move caudally, gets stuck
Most common location: base of heart

Question 18

Esophageal stricture

Answer 18

Fibrous tissue appearing secondary to trauma

Question 19

What causes esophageal diverticulum

Answer 19

Secondary to FB, strictures
Congenital

Question 20

Type 1/ Classic/ Sliding hiatal hernia

Answer 20

Cardiac of the stomach and abdominal esophagus slides through the esophageal hiatus of the diaphragm in thoracic cavity
Common with brachys

Question 21

Type 2/ Paraesophageal hiatal hernia

Answer 21

Piece of the sotmach hernaites through the esophageal hiatus of the diaphrahm and now in the throacic cavity

Question 22

Type 3 hiatal hernia

Answer 22

Characteristics of both types 1 and 2 with concurrent axial and para-esophageal herniation

Question 23

Type 4 hiatal hernia

Answer 23

Surgical emergency
Abdominal organs (colon, spleen, bowel) + piece of the stomach protrude the side of the esophageal hiatus into the thoracic cavity

Question 24

What’s seen on a radiograph with GDV

Answer 24

Functional Ileus
Esophageal dilation
Small CdVC
Displaced pylorus with gas

Question 25

What causes functional ileus

Answer 25

Secondary to gastroenteritis (medically related affecting the GIT)

Question 26

Mechanical ileus

Answer 26

Something in the GIT preventing movement of food forward
Two populations of small bowel

Question 27

Functional Ileus

Answer 27

Synchrony of peristaltic waves thrown off → food slushes back and forth → SI bacterial overgrowth → gas filled small bowel loops

Question 28

Small bowel measurement

Answer 28

Dog: <1.6 x height of L5
Cat: <12 mm

Question 29

Differentials to mechanical ileus

Answer 29

FB obstruction (not always seen)
Mass (hx is the difference + chr. signs and ileus)
Strictures
Torsion
Extraluminal mass (decompress GI)

Question 30

Where are linear FBs lodged in cats?

Answer 30

Base of the tongue