Gastric/ Esophageal

Question 1

Sutton
PO morbidity of Esophageal Surgery
JAVMA 2016

Answer 1

Complications
~Dogs 54%
~Cats 33%
*Respiratory immediate
Associated with partial esophagectomy and R&A

Delayed complications
~Regurg
~Esophageal stricture
*associated with a mass lesion, increased lesion size

Death 10%
~pneumomediastinum
~leukopenia

Question 2

Morams
Gastric carcinoma
VetSurg 2019

Answer 2

Major PO complications 20%
~septic 10%

Median Progression-Free Interval 54d

MST 178d

Intra-op complications = increased death ratio 3.5

Chemo improved survival

Question 3

Duffy
Staple line gastrectomy
VetSurg 2021

Answer 3

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

Question 4

O’Neill
GDV in dogs in UK ER
JSAP 2017

Answer 4

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%

Question 5

Belch
Tube Gastropexy management of GDV
JSAP 2017

Answer 5

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

10% major complications

84% were initially fed via the gastrostomy tube postoperatively

Question 6

White
Delay Sx GDV
JAVMA 2021

Answer 6

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.

Question 7

Broux
Manipulations to detect sliding hiatal hernia in BOAS
VetSurg 2018

Answer 7

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

Question 8

Conte
CT of Esophageal hiatus
VetSurg2020

Answer 8

Mean esophageal hiatus: aortic ratio
BOAS > Non-BOAS

Esophageal hiatus measurements weight-matched
BOAS > Non-BOAS

Question 9

Reeve
Hiatal hernia in brachycephalic with fluoroscopy
JSAP 2017

Answer 9

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

Question 10

Grimes
Gastroesophageal intussusception
JAVMA 2020

Answer 10

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

Question 11

Webb
Length and # sutures lines in a gastropexy
VetSurg 2019

Answer 11

Load to failure
2 cm < 4 cm

No difference in # sutures lines

Question 12

Phases of swallowing

Answer 12

Oropharyngeal Phase

• Oral: prehension
• Pharyngeal: pharyngeal contractions
• Pharyngoesophageal: cricopharyngeal & thyropharyngeal m relax

Esophageal Phase

Gastroesophageal Phase

Question 13

The one vascular ring anomaly approached from the right

Answer 13

Persistent right ligamentum arteriosum with normal L aortic arch

Question 14

Which gastric cells produce acids

Answer 14

Parietal

Question 15

Which gastric cells produce mucous

Answer 15

Mucous neck cells

Question 16

Which gastric cells produce pepsinogen

Answer 16

Chief

Question 17

Branches of Celiac a

Answer 17

Splenic
-left gastroepiploic to short gastrics

Hepatic

• Right gastric
• Right gastroepiploic

Left Gastric