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Small Animal Surgery > 4 - Esophagus > Flashcards

4 - Esophagus Flashcards

(47 cards)

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1
Q

What are the main indications for sx of the esophagus?

A

foreign bodies and esophageal feeding tubes

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2
Q

What are clinical signs associated with potential esophageal sx?

A

Regurgitation, dysphagia, ptyalism, altered appetite, coughing, dyspnea, fever, weight loss

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3
Q

What is regurgitation?

A

PASSIVE expulsion from esophagus

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4
Q

What is vomiting?

A

Centrally mediated reflux;

FORCEFUL expulsion from stomach or duodenum

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5
Q

What are the 3 approaches to esophageal sx?

A
  1. Cervical
  2. Thoracic
  3. Abdominal/transdiaphragmatic
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6
Q

Where does the thoracic esophagus get its blood supply?

A

Bronchoesophageal aa and segmental aortic branches

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7
Q

What are the 5 techniques that can be done on the esophagus?

A
  1. Esophagostomy
  2. Esophagectomy
  3. Esophagopexy
  4. Esophageal patching
  5. Esophageal substitution
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8
Q

What are the 4 layers of the esophagus?

A
  1. Mucosa
  2. Submucosa
  3. Muscularis
  4. Adventitia
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9
Q

What does the mucosa of the dog esophagus look like?

A

linear striations

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10
Q

What does the mucosa of the cat esophagus look like?

A

Distal portion = circular folds, herringbone pattern

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11
Q

What is the holding strength layer of the esophagus?

A

submucosa

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12
Q

The esophageal muscularis includes segmental _____.

A

blood supply

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13
Q

The esophagus has an adventitia instead of a _____. Because of this, the esophagus does not _____.

A

serosa, heal very well

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14
Q

What are 5 factors challenging healing of the esophagus?

A
  1. Segmental blood supply
  2. Lack of serosa and no omentum
  3. Constant motion and bolus distention
  4. Intolerance of longitudinal stretching/tension
  5. Passage of food and saliva
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15
Q

What layer should be incorporated in all sutures?

A

submucosa

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16
Q

What is an esophagotomy?

A

Incision into the esophageal lumen

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17
Q

What is an esophagectomy?

A

Partial resection of the esophagus

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18
Q

What is an esophagopexy?

A

Suture esophagus to another structure

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19
Q

What is esophageal patching?

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A

Reinforce defect with muscle or other tissue

20
Q

What is esophageal substitution?

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A

Replace esophagus with other tissue (skin tube or intestine)

21
Q

Up to ___% of the circumference can be debrided and edges apposed.

22
Q

What side of the esophagus should be sutured first and why?

Study These Flashcards
A

Far side because you don’t have access to both sides

23
Q

What side is the esophagus tacked to in an esophagopexy?

24
Q

What are 3 complications of esophageal surgery?

Study These Flashcards
A
  1. Leakage
  2. Stricture formation
  3. Fistula formation
25
What are the 8 special considerations related to surgery of the esophagus?
1. Suspect concurrent aspiration pneumonia and esophagitis 2. Perforations may be fatal 3. Relatively fixed position; 3-5 cm resectable 4. No serosa - slower sealing 5. Segmental blood supply 6. Constant motion: bolus passage and respiration 7. 2-layer simple interrupted blosure, luminal knots 8. No omentum
26
What conditions call for esophageal surgery?
Foreign bodies, strictures, diverticula, paraesophageal abscess, tumors, hiatal hernia, cricopharyngeal achalasia, vascular ring anomalies
27
What esophageal condition is not surgical?
Congenital/acquired megaesophagus
28
Most esophageal foreign bodies can be removed \_\_\_\_\_. Surgical removal is indicated if _____ or \_\_\_\_\_.
endoscopically, perforated, can't be safely dislodged
29
What is an esophageal stricture and what are clinical signs?
Circumferential mucosal trauma; Regurgitation +/- perforation
30
What are the types of esophageal diverticula and how often do we see them?
Acquired or congenital (pulsion or traction); They are rare
31
How common are esophageal tumors and what type are they, usually?
They are rare and usually malignant
32
What is the prognosis for an esophageal tumor once it is diagnosed?
guarded/poor because it is usually at an advanged stage at the time of diagnosis
33
What is the most common cause of hiatal hernias and what breeds are likely to get them?
Most are congenital; Brachycephalic breeds more prone - Sharpei, English bulldogs
34
What are clinical signs of hiatal hernias?
Intermittent regurgitation, dysphagia, hypersalivation
35
What is the prognosis for medical treatment of a hiatal hernia?
fair/good
36
What is the prognosis for surgical treatment of a hiatal hernia?
fair/good
37
What is gastroesophageal intussusception?
Invagination of the stomach and other organs into the esophagus
38
What dogs commonly get gastroesophageal intussusception?
Young/large breed - EX: German Shepherd
39
What 3 things can cause cricopharyngeal dysphagia?
1. Achalasia 2. Dyssynchrony 3. Myasthenia gravis
40
What is achalasia? What breeds are prone?
Failure of cricopharyngeus muscle to completely relax or open --\> interruption of bolus passage from oropharynx to esophagus Idiopathic hypertrophy of CP m.; Mini-Dachshunds, Small breeds
41
What is dyssynchrony? What breeds are prone?
Inappropriate bolus presentation to the UES; Idiopathic - suspected neuropathy; Golden Retrievers, Cocker Spaniels
42
When can achalasia be diagnosed and why?
At weaning - switch from liquid to solid food
43
What is the most common vascular ring anomaly and what can it lead to?
Persistent R aortic arch (95%); Can lead to megaesophagus (cranial +/- caudal)
44
What breed is most prone to vascular ring anomalies?
German Shepherds
45
What should be ruled out if you suspect a vascular ring anomaly, especially in GSD?
Congenital megaesophagus
46
What are indications for placement of an esophageal feeding tube?
Oropharyngeal disease/trauma, long term feeding
47
What are contraindications for an esophageal feeding tube?
Esophageal disease

Small Animal Surgery (17 decks)

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