Diseases of the Esophagus Flashcards
(49 cards)
What induces primary peristalsis?
the swallow reflex (involuntary)
When and where does secondary peristalsis occur?
in the thoracic esophagus in response to esophageal distention
Define Esophageal dysphagia
disorders of transport of bolus through the esophagus to the stomach
What are clinical signs of esophageal dysphagia?
-REGURGITATION
-odynophagia (pain on swallowing)
-exaggerated swallowing (multple attempts)
-Ptyalism (too much saliva)
-fever, cough, dyspnea
If you have a patient that you suspect has an esophageal dysphagia disorder, what are their vitals like + why
will have a fever, cough and dypsnea (labored breathing)
which could be:
secondary to aspiration pneumonia or esophageal perforation or
laryngitis due to acid burn (paired with a hacking cough)
If an owner is concerned about their pet vomiting (and it is true vomiting) where can I localize the underlying issue?
stomach or upper small intestine OR
neurologic cause
What are some clinical signs that may help me determine if a pet is truly vomiting?
it is preceded by: retching, vocalization, and repeated abdominal contractions
What is the exception to regurgitation occuring seconds after eating?
In the case of a giant dilated megaesophagus, then regurg can occur hours after.
If a patient is regurgitating, where can we localize the pathology?
to the esophagus.
What are my concerns if a pet presents with regurgitation?
esophageal disease
risk of aspiration pneumonia
bc regurg occurs w/o airway protection
What are some causes of esophageal dysphagia?
-esophagitis
-esophageal obstruction
-megaesophagus
-vascular ring anomaly
-esophageal neoplasia
My patient is showing CS of Esophageal dysphagia. If i wanted to diagnose esophagitis, how would I go about that?
Radiographs - to r/o other causes such as: GERD (air in distal esophagus) or focal esophageal dilation
Endoscopy!!!! is the most sensitive method
Via endoscopy, I diagnose my canine patient with esophagitis. what is my tx plan?
- remove the underlying cause (FB)
2.) Feed a highly digestable GI diet (Fat restricted!) because it promotes gastric emptying
3.) If it was a severe case and my p couldn’t keep food down, discontinue use for 24-48 hours
RX the following:
-omeprazole- antacid that lowers stomach acidity , sucralfate slurry- binds to damaged mucosa in esophagus + stomach
What are the types of esophageal obstruction?
intraluminal (FB)
intramural- (strictures/neoplasia )
peri-esophageal
What are the three most common locations for a esophageal foreign body?
thoracic inlet, base of the heart and diaphragmatic hiatus (right before it enterns the stomach)
Why are esophageal foreign bodies problematic?
they stimulate secondary peristalsis which can result in severe ulcerative esophagitis, esophageal perforation and esophageal stricture
What are some clinical signs of an esophageal foreign body?
anorexia, hypersalivation + drooling, odynophagia (may extend neck) and regurgitation
If I am suspicious of an esophageal foreign body, what diagnostics should I conduct?
cervical and thoracic rads (w/ or w/o contrast) I want a laternal neck and 3 view chest rads
I can also diagnose via endoscopy
After removing a foreign body, what are my post-removal treatment suggestions?
tx for esophagitis - rx: omeprazole, sucralfate
consider esophagostomy tube placement if we are worried about a stricture
What clinical signs correlate to a esophageal stricture?
-insult/injury occured to esophagus 1-4 weeks ago: this could be a FB,
- hx of anesthesia (gastroesophageal reflux),
-doxycycline or clindamycin hx in cats,
-persistant vomiting
How do I diagnose an esophageal stricture?
via contrast esophogram (Rads or fluroscopy)
or endoscopy
What are my treatment options for an esophageal stricture? What about prognosis?
-endoscopic balloon dilation w/ local steroid injections however this only works for thoracic strictures.
-feeding tube: esophagostomy tube or gastrostomy tube
- patient will have to eat a canned or slurry diet for the rest of its life.
In what animals am I more likely to see idiopathic megaesophagus in?
dogs! it is the most common cause of chronic regurgitation in dogs. it is rare in cats.
can be congenital or acquired.
How do I r/o a secondary cause of megaesophagus due to myasthenia gravis?
obtain an acetylcholine receptor antibody titer. if negative, repeat in 2-3 months
