Digestion & Metabolism 2: Esophageal Sx (Holt)

Question 1

the esophagus has 3 qualities…

Answer 1

1. TOUGH/DISTENSIBLE to swallow hard material
2. GOOD MUSCULAR INTEGRITY/BLOOD SUPPLY to move boluses along

Question 2

CRICOPHARYNGEAL ACHALASIA…
= what is it? & what 2 things does it cause the patient to do?

commonality in dogs?

2 breeds predisposed?

Answer 2

= FAILURE for CRICOPHARYNGEUS MUSCLE to RELAX so that FOOD REMAINS IN PHARYNX, stimulating…
1. FORCEFUL pharyngeal movements
2. regurgitation

UNCOMMON in dogs?

2 breeds predisposed?
1. COCKER spaniel
2. SPRINGER spaniel

Question 3

what is the MAJOR CONCERN in esophageal foreign bodies?

how can esophageal foreign bodies cause RESPIRATORY signs?

Answer 3

PRESENCE of foreign body can cause SPASM OF ESOPHAGEAL MUSCLES, and if they’re HARD/LONG enough, can DECREASE BLOOD SUPPLY –> NECROSIS

RESPIRATORY signs? = if FB is big enough, can PRESS ON TRACHEA & cause DYSPNEA

Question 4

what 2 kinds of sutures can we use after SURGICALLY removing FB?

what is the HOLDING layer in the esophagus? why is this important?

if we have an esophageal FB towards the BASE of the heart, WHICH SIDE OF THE BODY SHOULD WE ENTER/WHY?

if we have an esophageal FB in the CAUDAL THORACIC, which side should we enter?

Answer 4

2 sutures for esophagus?
1. SIMPLE CONTINUOUS
2. SIMPLE INTERRUPTED APPOSITIONAL (better)

HOLDING layer = SUBMUCOSA, has GOOD BLOOD SUPPLY & allows esophagus to HEAL

if near HEART BASE, enter on RIGHT SIDE TO AVOID AORTA

if CAUDAL THORACIC, then ENTER ON LEFT SIDE

Question 5

= what is the MOST COMMON/IMPORTANT cause of ESOPHAGEAL STRICTURE?

what intervention can cause this? & how? (2)

Answer 5

= REFLUX ESOPHAGITIS

can occur from SURGERY…
1. if dog was NOT adequately FASTED, then LES relaxes and ABNORMALLY ALLOWS REFLUX THROUGH FROM STOMACH –> ESOPHAGUS
2. the longer the caustic material sits in esophagus, MORE LIKELY TO CAUSE STRICTURE

Question 6

ESOPHAGEAL MALIGNANT NEOPLASIA is ____, and usually we ____ perform intervention because….

Answer 6

RARE, DON’T perform intervention because usually ALREADY TOO LARGE

Question 7

ANY animal that comes in that’s been RETCHING, VOMITING or REGURGITATING, we should be concerned with WHAT?

Answer 7

ASPIRATION PNEUMONIA

Question 8

CRICOPHARYNGEAL ACHALASIA…

3 other DDxs?

diagnosis is confirmed via…

treatment?

Answer 8

3 other DDxs?
1. PHARYNGEAL FBs
2. MASSES
3. MYOSITIS/PARALYSIS

CONFIRMED via VIDEOFLUOROSCOPIC BARIUM SWALLOW while animal is AWAKE

treatment?
= CRICOPHARYNGEUS MYOTOMY (cut muscle on BOTH SIDES)
GOOD RESULTS