Canis ISSN: 2398-2942

Esophagus: stricture

Contributor(s): James Simpson, Kenneth Simpson

Introduction

  • Cause:
    • Post-anesthetic stricture (most common).
    • Traumatic foreign bodies.
    • Ingestion of caustic materials (rare)/medication, eg doxycycline.
    • Accidental trauma.
  • Most common sequel to esophagitis.
  • Signs: dysphagia, salivation, pain on swallowing, regurgitation - developing over several weeks.
  • Site: thoracic inlet and between base of heart - cardia.
  • Important sequelae: aspiration of regurgitated ingesta, megaesophagus cranial to stricture.
  • Treatment: dilation by serial bougienage or balloon dilation.
  • Prognosis: guarded to poor, frequently recur.

Pathogenesis

Etiology

  • Acquired at time of general anesthesia (most common).
  • Trauma due to foreign bodies Esophagus: foreign body.
  • Ingestion of caustic materials (rare)/medication, eg doxycycline, benzalkonium chloride.
  • Subsequent upon esophageal surgery.
  • Accidental trauma.
  • Associated with persistent right aortic arch Vascular ring anomalies.
  • Occasionally neoplasia.
  • Idiopathic.

Specific

  • Prior general anesthesia for abdominal surgery.

Pathophysiology

  • Post-anesthetic stricture (most common) - erosive reflux esophagitis due to pooling of acidic gastric contents following relaxation of gastro-esophageal sphincter during general anesthetic.
  • Clinical signs develop within 1-6 weeks of anesthetic episode/inciting cause.
  • Initially fluids tolerated - eventually these regurgitated also.
  • Can be anywhere along thoracic esophagus.
  • Aspiration of regurgitated ingesta and development of megesophagus cranial to stricture - important sequelae.

Timecourse

  • Clinical signs develop within 1-6 weeks of inciting cause.

Diagnosis

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Treatment

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Prevention

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Outcomes

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Further Reading

Publications

Refereed papers

  • Recent references from PubMed and VetMedResource.
  • Leib M S, Dinnel H, Ward DL et al (2001) Endoscopic balloon dilation of benign esophageal strictures in dogs and cats. JVIM 15 (6), 547-552 PubMed.
  • Weyrauch E A & Willard M D (1998) Esophagitis and benign esophageal strictures. Comp Cont Ed Prac Vet 20 (2), 203-212 VetMedResource.
  • Harai B H et al (1995) Endoscopically guided balloon dilation of benign structures in six cats and seven dogs. J Vet Intern Med 9 (5), 332-335 WileyOnlineLibrary.
  • Willard M D, Dellers E K & Fossum T W (1994) Iatrogenic tears associated with ballooning of esophageal strictures. JAAHA 30 (5), 431-435 VetMedResource.
  • Hurley et al (1993) Left aortic and right liganatum anteriosum causing esophageal obstruction in a dog. JAVMA 203 (3), 410-412 PubMed.
  • Johnson K A et al (1992) Correction of cervical esophageal stricture in a dog by creation of a traction diverticulum. JAVMA 201 (7), 1045-1048 PubMed.
  • Flanders J A (1989) Problems and complications associated with esophageal surgery. Prob Vet Med 1 (2), 183-194 PubMed.
  • Burk R L, Zawie D A & Garvey M S (1987) Balloon catheter dilation of intramural esophageal strictures in the dog and cat - a description of the procedure and report of 6 cases. Semin Vet Med Surg 2 (4), 241-247 VetMedResource.
  • Hardie et al (1986) Baller dilatation for treatment of esophageal stricture - a case report. JAAHA 23, 547-550.


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