Esophagus and Stomach Flashcards
What are the the types of contrast agents?
Positive: barium and iodine
Negative: air
What are the 2 types of iodine contrast agents
Non-ionic: safer (use if might be absorbed)
Ionic
Barium sulphate
Insoluble in water
Not absorbed by patient
Only used in the GI tract
Why use barium over iodinated contrast agents
Coats the mucosa well
Adheres to inflamed tissue in the GI tract
Iodinated is hyperosmolar: stimulate fluids to enter GI (dehydration)
Benefits of iodinated contrast agents
If it leaks out of the GI tract, won’t cause problems
When are ionic contrast agents use?
Joint infusion studies
What should you do before performing contrast studies of the esophagus?
Plain/survey rads
only follow up with contrast studies if unsure of dx
Contrast studies for the esophagus
Admin barium orally then immediately get lateral and VD/DV of neck and thorax
Gets rads while feeding patient barium in lateral
What’s another way to get contrast studies for the esophagus?
Barium food bolus
Helps visualize stricture or defect in esophagus (food won’t pass through defect)
Redundant esophagus / Hypermotile esophagus
@ the thoracic inlet food doesn’t get propelled to the cd. esophagus quickly and contrast pools
In Shar-peis
Cricopharyngeal Achalasia
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
What are patients with cricopharyngeal achalasia predisposed to?
Aspiration pneumonia
Dx and tx for cricopharyngeal achalasia
Contrast study and fluoroscopy
Sx cut cricopharyngeal m.
Megaesophagus
Focal (prevents movement of food from oral cavity to stomach) or diffuse
Consequences of megaesophagus
Ability to swallow impaired
Aspiration pneumonia
What’s the most common vascular ring anomaly
Persistent right aortic arch (classic finding: regurg after switching from milk to solid food)
Esophageal FB/ Trauma
Ingested something too big and doesn’t move caudally, gets stuck
Most common location: base of heart
Esophageal stricture
Fibrous tissue appearing secondary to trauma
What causes esophageal diverticulum
Secondary to FB, strictures
Congenital
Type 1/ Classic/ Sliding hiatal hernia
Cardiac of the stomach and abdominal esophagus slides through the esophageal hiatus of the diaphragm in thoracic cavity
Common with brachys
Type 2/ Paraesophageal hiatal hernia
Piece of the sotmach hernaites through the esophageal hiatus of the diaphrahm and now in the throacic cavity
Type 3 hiatal hernia
Characteristics of both types 1 and 2 with concurrent axial and para-esophageal herniation
Type 4 hiatal hernia
Surgical emergency
Abdominal organs (colon, spleen, bowel) + piece of the stomach protrude the side of the esophageal hiatus into the thoracic cavity
What’s seen on a radiograph with GDV
Functional Ileus
Esophageal dilation
Small CdVC
Displaced pylorus with gas
What causes functional ileus
Secondary to gastroenteritis (medically related affecting the GIT)
Mechanical ileus
Something in the GIT preventing movement of food forward
Two populations of small bowel
Functional Ileus
Synchrony of peristaltic waves thrown off → food slushes back and forth → SI bacterial overgrowth → gas filled small bowel loops
Small bowel measurement
Dog: <1.6 x height of L5
Cat: <12 mm
Differentials to mechanical ileus
FB obstruction (not always seen)
Mass (hx is the difference + chr. signs and ileus)
Strictures
Torsion
Extraluminal mass (decompress GI)
Where are linear FBs lodged in cats?
Base of the tongue
