Ex 1 - Esophagus Flashcards Preview

726 Imaging Interpretation > Ex 1 - Esophagus > Flashcards

Flashcards in Ex 1 - Esophagus Deck (17):
1

Two sphincters of the esophagus

1. Cricopharyngeal sphincter/cranial esophageal sphincter
2. Caudal esophageal sphincter

2

Wall layers of esophagus

1. Mucosa: keratinized stratified squamous epithelium
2. Submucosa: loose network of fibrous CT w/ varying quantities of sm mm & mucous glands
3. Muscularis: striated mm in the dog; terminal 1/3 is striated in the cat
4. Adventitia/CT: There is NO outer serial layer in the esophagus

3

Difference between dogs and cats? (esophagus)

Dogs: all striated muscle

Cats: distal 1/3 is smooth muscle

4

Clinical signs of esophageal dz (4)

1. Regurgitation
2. Dysphagia
3. Abnormal swallowing
4. Gagging, retching

5

Secondary complications of esophageal dz (4)

1. weight loss
2. failure to gain weight or grow normally
3. chronic or recurrent respiratory problems
4. Aspiration pneumonia, tracheitis, nasal discharge

6

Normal rad appearance - esophagus

Normally can't see it

Silhouettes (border effacement) w/ adjacent soft tissues in mediastinum

There is occasional fluid accumulation in the caudal thoracic esophagus (usually LRL view)
- creates an oblong region of soft tissue opacity - not to be confused for a mass

***the absence of abnormal esophageal rad findings does NOT R/O esophageal dz --> if CS then consider contrast study

7

Aerophagia

Very small volume of air in the lumen

* will be transient
* common sites:
1. immediately caudal to the UES
2. thoracic inlet
3. ***dorsal tot he heart base just cranial to the tracheal bifurcation

8

Effect of general anesthesia - esophagus

May cause marked dilation of a normal esophagus

* mimics megaesophagus, but recovers spontaneously when recovered from anesthesia

9

Vascular Ring Anomaly

Congenital heart abnormalities (ex. PRAA) --> cause compression (stricture) of the esophagus

*Esophagram can be helpful to determine if there is atony caudal to the stricture

10

Redundant Esophagus (U-shaped bend)

Incidental finding

Young dogs or brachycephalic breeds - can be problematic

Thoracic rads may be normal or show some gas accumulation near thoracic inlet

Peristalsis is normal

*Contrast may accumulate temporarily in a redundant section and can appear as an out pouching as w/ an esophageal diverticula

11

Rad signs assoc'd with Megaesophagus

* Tracheal stripe sign
- between luminal gas of the trachea and air w/in the esophagus
- silhouette sign of combined thickness of the tracheal and esophageal walls

* Longus colli mm sign

* esophagus visible caudal to the heart

* the "V" sign on the VD rad

* Food (granular soft tissue/gas mixture can be seen in a dilated esophagus; widened mediastinum; displacing trachea ventrally)

* Secondary findings: Aspiration pneumonia

12

Which lateral view will show dz in the right middle lung lobe?

LLR

13

Which view will should dz in the left lung lobes?

RLR???

14

Pilled cat --> megaesophagus?

Esophageal stricture from esophagitis resulting from pilling cats

15

Most common VRA

PRAA: esophagus is trapped by the heart, PRAA, main pulmonary artery and ligament arteriosum

* Dilation of the esophagus caudal to the PRAA may indicate concurrent esophageal dysfunction that may persist even when the vascular ring anomaly is corrected
-- peanut shape on VD

16

FB predeliction sites

1. Thoracic inlet
2. Heart base
3. Esophageal hiatus

17

Rad findings - perforated esophagus

1. mild to moderate pleural effusion
2. widening of the mediastinum, mediastinal mass
3. pneumomediastinum
4. varying amounts of intraluminal esophageal gas or fluid